MEDICARE: MS. CAITLIN DUGAN PAGE MS 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
1	225X00000X	Occupational Therapist	056007604	IL

General Provider Information

NPI Number	:	1073780144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAITLIN DUGAN PAGE MS OTR/L

Provider Business Mailing Address
First Line	:	4751 N ARTESIAN AVE APT 201
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3387
Country	:	US
Telephone Number	:	773-292-1684
Fax Number	:

Provider Business Practice Location Address
First Line	:	4751 N ARTESIAN AVE APT 201
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3387
Country	:	US
Telephone Number	:	773-292-1684
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	05/08/2008

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