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NPI Code Detail

MEDICARE: LAURA ELENA DUARTE PARRA OTR/L

MEDICARE: LAURA ELENA DUARTE PARRA 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
1106S00000XBehavior TechnicianRBT-20-132959IL
2225X00000XOccupational Therapist056015389IL

General Provider Information

NPI Number : 1255945531
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ELENA DUARTE PARRA OTR/L
Provider Business Mailing Address
First Line : 2518 1ST AVE
Second Line :
City : RIVER GROVE
State : IL
Zip : 60171-1743
Country : US
Telephone Number : 773-517-4380
Fax Number :
Provider Business Practice Location Address
First Line : 2400 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3936
Country : US
Telephone Number : 773-389-2202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2020
Last Update Date : 04/17/2023

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Directions to “ LAURA ELENA DUARTE PARRA OTR/L” Practice Location

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