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General NPI Number Information
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NPI Number | 1992351605
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Entity Type | Individual
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Provider Name | CLAIRE JEANETTE MAZUREK OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/18/2019
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Last Update Date | 08/18/2019
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Provider Practice Location Address
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Address Line | 8975 W GOLF RD
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City | NILES
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State | IL
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Zip | 60714-5821
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Country | US
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Telephone | 847-296-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 6214 N MELVINA AVE
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City | CHICAGO
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State | IL
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Zip | 60646-3719
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Country | US
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Telephone | 773-814-5532
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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 | 056.008876
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License Number State | IL
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