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NPI Code Detail

MEDICARE: ELISE KRAUSE OTD, OTR/L

MEDICARE: ELISE KRAUSE OTD, 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
1225X00000XOccupational Therapist056.013637IL

General Provider Information

NPI Number : 1407448079
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISE KRAUSE OTD, OTR/L
Provider Business Mailing Address
First Line : 1049 N PAULINA ST APT 1C
Second Line :
City : CHICAGO
State : IL
Zip : 60622-3897
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8 S MICHIGAN AVE STE 2100
Second Line :
City : CHICAGO
State : IL
Zip : 60603-3337
Country : US
Telephone Number : 312-392-1640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2021
Last Update Date : 03/16/2021

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