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General NPI Number Information
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NPI Number | 1730554320
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Entity Type | Individual
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Provider Name | AUDREY ANN PHILLIPS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 06/10/2020
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Provider Practice Location Address
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Address Line | 355 EAST ERIE STREET
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City | CHICAGO
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State | IL
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Zip | 60611-2654
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Country | US
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Telephone | 312-238-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 23 W SUFFIELD DR
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-2466
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Country | US
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Telephone | 224-659-4998
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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 | 1869
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License Number State | HI
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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 | OT18348
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056010799
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License Number State | IL
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