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General NPI Number Information
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NPI Number | 1700916889
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Entity Type | Organization
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Legal Business Name | GANFIELD MFR THERAPEUTICS LTD
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 1125 N DELANY RD
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City | GURNEE
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State | IL
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Zip | 60031-2007
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Country | US
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Telephone | 847-244-7070
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Fax | 847-244-7071
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Provider Business Mailing Address
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Address Line | 1125 N DELANY RD
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City | GURNEE
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State | IL
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Zip | 60031-2007
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Country | US
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Telephone | 847-244-7070
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Fax | 847-244-7071
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MS. ELIZABETH GANFIELD
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Credential | O.T.
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Telephone | 847-244-7070
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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 | 056000230
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License Number State | IL
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