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General NPI Number Information
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NPI Number | 1790452654
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Entity Type | Individual
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Provider Name | JAMES WALTER CHAMALES OTR/L
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Gender | Male
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 4061 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2611
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Country | US
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Telephone | 888-693-6437
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Fax |
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Provider Business Mailing Address
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Address Line | 1860 PAYSPHERE CIR
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City | CHICAGO
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State | IL
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Zip | 60674-0018
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Country | US
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Telephone | 630-967-2000
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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 | 056.014222
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License Number State | IL
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