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NPI Code Detail

MEDICARE: KATHLEEN PRATHER

MEDICARE: KATHLEEN PRATHER
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
1224Z00000XOccupational Therapy Assistant057003270IL

General Provider Information

NPI Number : 1558617357
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN PRATHER
Provider Business Mailing Address
First Line : 3902 CROWWOOD DR
Second Line : APT #203
City : CHAMPAIGN
State : IL
Zip : 61822-3585
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 801 N LOGAN AVE
Second Line : THERAPY DEPARTMENT
City : DANVILLE
State : IL
Zip : 61832-3715
Country : US
Telephone Number : 217-443-3106
Fax Number : 217-443-3187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2012
Last Update Date : 07/30/2012

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Directions to “ KATHLEEN PRATHER ” Practice Location

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