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General NPI Number Information
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NPI Number | 1932988813
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Entity Type | Individual
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Provider Name | ALICIA HELEN MATHEW OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 9600 GROSS POINT RD
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City | SKOKIE
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State | IL
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Zip | 60076-1214
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Country | US
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Telephone | 847-677-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 9137 NEW ENGLAND AVE
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City | MORTON GROVE
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State | IL
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Zip | 60053-2369
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Country | US
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Telephone | 224-522-4781
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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 | 056014266
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License Number State | IL
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