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General NPI Number Information
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NPI Number | 1770970857
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Entity Type | Individual
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Provider Name | ANNALIESE MARIE LOO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3551 HIGHLAND AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2100
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Country | US
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Telephone | 630-275-2600
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Fax | 630-275-2698
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Provider Business Mailing Address
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Address Line | 28594 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1285
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Country | US
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Telephone | 630-859-6800
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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 | 056.010941
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License Number State | IL
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