MEDICARE: MRS. MARINDA STOPFORTH

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	56006845	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558697136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARINDA STOPFORTH

Provider Business Mailing Address
First Line	:	120 OSLER
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-7429
Country	:	US
Telephone Number	:	630-527-3375
Fax Number	:	630-527-3380

Provider Business Practice Location Address
First Line	:	120 OSLER
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-7429
Country	:	US
Telephone Number	:	630-527-3375
Fax Number	:	630-527-3380

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

Provider Enumeration Date	:	11/02/2009
Last Update Date	:	11/02/2009

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Directions to “ MRS. MARINDA STOPFORTH ” Practice Location

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