=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679706121
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMY ZIER & ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2009
-----------------------------------------------------
Last Update Date | 09/01/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2619 N HALSTED ST
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60614-2301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-857-5578
-----------------------------------------------------
Fax | 773-755-7792
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2619 N HALSTED ST
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60614-2301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-857-5578
-----------------------------------------------------
Fax | 773-755-7792
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF OCCUPATIONAL THERAPY
-----------------------------------------------------
Name | MRS. AMY ZIER
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 773-857-5578
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | IL-056003880
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------