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NPI Code Detail

MEDICARE: MIA ROSE LANSBERG

MEDICARE: MIA ROSE LANSBERG
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 Therapist

General Provider Information

NPI Number : 1316805468
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA ROSE LANSBERG
Provider Business Mailing Address
First Line : 1 W SUPERIOR ST APT 601
Second Line :
City : CHICAGO
State : IL
Zip : 60654-8809
Country : US
Telephone Number : 513-410-0775
Fax Number :
Provider Business Practice Location Address
First Line : 2833 N CLYBOURN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-8470
Country : US
Telephone Number : 847-604-0027
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/15/2026

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Directions to “ MIA ROSE LANSBERG ” Practice Location

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