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NPI Code Detail

MEDICARE: MARGARET WIEDT OTD, OTR/L

MEDICARE: MARGARET WIEDT OTD, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XN1300XNeurorehabilitation Occupational Therapist
2225X00000XOccupational Therapist056.016137IL

General Provider Information

NPI Number : 1043000292
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET WIEDT OTD, OTR/L
Provider Business Mailing Address
First Line : 3171 N ORCHARD ST APT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60657-9769
Country : US
Telephone Number : 330-801-4273
Fax Number :
Provider Business Practice Location Address
First Line : 1401 S CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1858
Country : US
Telephone Number : 773-522-2010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2025
Last Update Date : 05/22/2025

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