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General NPI Number Information
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NPI Number | 1386234235
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Entity Type | Individual
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Provider Name | KATHERINE IRENE KANTNER OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 6501 S PROMONTORY DR # 1003
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City | CHICAGO
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State | IL
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Zip | 60649-1002
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Country | US
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Telephone | 773-256-5777
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Fax |
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Provider Business Mailing Address
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Address Line | 1808 W ARMITAGE AVE APT 3
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City | CHICAGO
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State | IL
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Zip | 60622-1588
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Country | US
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Telephone | 630-244-1461
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.013744
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License Number State | IL
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