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NPI Code Detail

MEDICARE: MARGARET CUSACK

MEDICARE: MARGARET CUSACK
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 Therapist056013144IL

General Provider Information

NPI Number : 1205471893
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET CUSACK
Provider Business Mailing Address
First Line : 5902 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-5508
Country : US
Telephone Number : 773-552-3739
Fax Number :
Provider Business Practice Location Address
First Line : 1551 LAKE COOK RD
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-5651
Country : US
Telephone Number : 847-374-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2019
Last Update Date : 11/07/2019

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Directions to “ MARGARET CUSACK ” Practice Location

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