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General NPI Number Information
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NPI Number | 1962529867
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Entity Type | Individual
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Provider Name | MAUD MAKONI OTR,SIPT-C
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 3082 CATON FARM RD
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City | JOLIET
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State | IL
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Zip | 60435-1455
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Country | US
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Telephone | 815-577-9936
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Fax | 815-577-9938
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone | 866-370-8206
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Fax | 517-435-3670
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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 | 056005850
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License Number State | IL
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