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General NPI Number Information
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NPI Number | 1255945531
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Entity Type | Individual
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Provider Name | LAURA ELENA DUARTE PARRA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 2400 N SHEFFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60614-3936
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Country | US
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Telephone | 773-389-2202
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Fax |
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Provider Business Mailing Address
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Address Line | 2518 1ST AVE
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City | RIVER GROVE
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State | IL
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Zip | 60171-1743
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Country | US
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Telephone | 773-517-4380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-132959
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056015389
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License Number State | IL
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