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NPI Code Detail

MEDICARE: MICHELLE MARIE HODGES OTD, OTR/L

MEDICARE: MICHELLE MARIE HODGES 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 Therapist056016470IL

General Provider Information

NPI Number : 1689229635
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MARIE HODGES OTD, OTR/L
Provider Business Mailing Address
First Line : 1828 W WEBSTER AVE # 450
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2916
Country : US
Telephone Number : 708-365-4569
Fax Number :
Provider Business Practice Location Address
First Line : 1828 W WEBSTER AVE # 450
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2916
Country : US
Telephone Number : 708-365-4569
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2019
Last Update Date : 06/05/2025

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