MEDICARE: MS. KRISTINA GRAZINA RAZMA OT

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1457421117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTINA GRAZINA RAZMA OT

Provider Business Mailing Address
First Line	:	1733 W MELROSE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1003
Country	:	US
Telephone Number	:	773-406-5426
Fax Number	:

Provider Business Practice Location Address
First Line	:	1733 W. MELROSE ST.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1003
Country	:	US
Telephone Number	:	773-327-2816
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	04/12/2023

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