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NPI Code Detail

MEDICARE: FRANCINE PETRO COTA/L

MEDICARE: FRANCINE PETRO COTA/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
1224ZE0001XEnvironmental Modification Occupational Therapy Assistant057004036IL

General Provider Information

NPI Number : 1295128403
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANCINE PETRO COTA/L
Provider Business Mailing Address
First Line : 929 W FOSTER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1491
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 929 W FOSTER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1491
Country : US
Telephone Number : 773-654-5167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2015
Last Update Date : 03/12/2015

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Directions to “ FRANCINE PETRO COTA/L” Practice Location

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