=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184988982
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. LING ZHOU
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2012
-----------------------------------------------------
Last Update Date | 06/27/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 521 S LA GRANGE RD SUITE 204-A
-----------------------------------------------------
City | LA GRANGE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60525-6700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-482-9788
-----------------------------------------------------
Fax | 708-482-9789
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 521 S LA GRANGE RD SUITE 204-A
-----------------------------------------------------
City | LA GRANGE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60525-6700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-482-9788
-----------------------------------------------------
Fax | 708-482-9789
-----------------------------------------------------
=====================================================
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 | 056002006
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------