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NPI Code Detail

MEDICARE: DR. NICOLE MARIE REMBLOS MOLINA OTD, OTR/L

MEDICARE:  DR. NICOLE MARIE REMBLOS MOLINA  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 Therapist056.014352IL

General Provider Information

NPI Number : 1457027948
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE MARIE REMBLOS MOLINA OTD, OTR/L
Provider Business Mailing Address
First Line : 1962 N BISSELL ST STE 1
Second Line :
City : CHICAGO
State : IL
Zip : 60614-0558
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1962 N BISSELL ST STE 1
Second Line :
City : CHICAGO
State : IL
Zip : 60614-0558
Country : US
Telephone Number : 312-598-9991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2021
Last Update Date : 05/27/2023

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Directions to “ DR. NICOLE MARIE REMBLOS MOLINA OTD, OTR/L” Practice Location

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