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General NPI Number Information
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NPI Number | 1881710531
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Entity Type | Individual
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Provider Name | LAURA CONNOR OTR
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 3002 E DIVISION ST
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City | DIAMOND
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State | IL
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Zip | 60416-9486
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Country | US
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Telephone | 815-390-3566
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Fax | 815-364-0161
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Provider Business Mailing Address
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Address Line | 5835 E NORTH PRAIRIE DR
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City | MORRIS
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State | IL
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Zip | 60450-7308
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Country | US
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Telephone | 815-483-3303
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Fax | 815-531-1075
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056006304
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License Number State | IL
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