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NPI Code Detail

MEDICARE: KATI ECKERT OT

MEDICARE: KATI ECKERT 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
1225X00000XOccupational TherapistIL
2225X00000XOccupational Therapist056007572IL

Other Identifiers

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

General Provider Information

NPI Number : 1669574422
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATI ECKERT OT
Provider Business Mailing Address
First Line : 413 W MADISON ST
Second Line :
City : O FALLON
State : IL
Zip : 62269-1180
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 W A ST
Second Line :
City : BELLEVILLE
State : IL
Zip : 62220-1326
Country : US
Telephone Number : 618-234-4294
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 11/17/2017

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Directions to “ KATI ECKERT OT” Practice Location

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