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General NPI Number Information
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NPI Number | 1821799255
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Entity Type | Individual
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Provider Name | LAUREN ANNE GRALTON OT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 3232 LAKE AVE STE 1
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City | WILMETTE
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State | IL
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Zip | 60091-0005
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Country | US
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Telephone | 224-266-9411
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Fax |
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone |
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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 | 056-015275
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License Number State | IL
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