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NPI Code Detail

MEDICARE: JANINE DAWN FELCHLIN

MEDICARE: JANINE DAWN FELCHLIN
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
1224Z00000XOccupational Therapy Assistant057002066IL

General Provider Information

NPI Number : 1295080158
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANINE DAWN FELCHLIN
Provider Business Mailing Address
First Line : 199 WOODLAND DR
Second Line :
City : EDWARDSVILLE
State : IL
Zip : 62025-5347
Country : US
Telephone Number : 618-979-2076
Fax Number : 618-344-9356
Provider Business Practice Location Address
First Line : 601 W LINCOLN AVE
Second Line :
City : CASEYVILLE
State : IL
Zip : 62232-1306
Country : US
Telephone Number : 618-344-9355
Fax Number : 618-344-9356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2012
Last Update Date : 07/17/2012

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