MEDICARE: JULIE GRIFFIN

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

General Provider Information

NPI Number	:	1215313721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE GRIFFIN

Provider Business Mailing Address
First Line	:	4619 N RAVENSWOOD AVE STE 300
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4579
Country	:	US
Telephone Number	:	708-408-6422
Fax Number	:

Provider Business Practice Location Address
First Line	:	4619 N RAVENSWOOD AVE STE 300
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4579
Country	:	US
Telephone Number	:	708-408-6422
Fax Number	:

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

Provider Enumeration Date	:	08/06/2015
Last Update Date	:	06/20/2024

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Directions to “ JULIE GRIFFIN ” Practice Location

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