=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184785032
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHLEEN M CUMMINGS OTR.L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 S MILWAUKEE AVE DAYHAB
-----------------------------------------------------
City | LIBERTYVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60048-3204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-990-5805
-----------------------------------------------------
Fax | 847-573-4201
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5411 N LAPORTE AVE
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60630-1529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-990-5805
-----------------------------------------------------
Fax | 847-573-4201
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------