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General NPI Number Information
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NPI Number | 1467611095
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Entity Type | Individual
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Provider Name | JEANINE D ANGELI OTR
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Gender | Female
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 5000 W CHAMBERS ST
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City | MILWAUKEE
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State | WI
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Zip | 53210-1650
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Country | US
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Telephone | 414-447-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 HERON CREEK DR
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City | SYCAMORE
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State | IL
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Zip | 60178-8863
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Country | US
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Telephone | 262-573-4306
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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 | 1867026
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License Number State | WI
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