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NPI Code Detail

MEDICARE: MEGHAN M JENNINGS OTR/L

MEDICARE: MEGHAN M JENNINGS 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
1225X00000XOccupational Therapist05600005991IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001634912OTHERILBLUE CROSS BLUE SHIELD #

General Provider Information

NPI Number : 1063526598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN M JENNINGS OTR/L
Provider Business Mailing Address
First Line : 9556 S SPRINGFIELD AVE
Second Line :
City : EVERGREEN PARK
State : IL
Zip : 60805-2013
Country : US
Telephone Number : 773-259-1272
Fax Number : 773-233-9950
Provider Business Practice Location Address
First Line : 9556 S SPRINGFIELD AVE
Second Line :
City : EVERGREEN PARK
State : IL
Zip : 60805-2013
Country : US
Telephone Number : 773-259-1272
Fax Number : 773-233-9950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/08/2007

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Directions to “ MEGHAN M JENNINGS OTR/L” Practice Location

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