MEDICARE: ELAINE FLEMING KEMPERS 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		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	225X00000X	OTHER	IL	TAXONOMY

General Provider Information

NPI Number	:	1689736548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE FLEMING KEMPERS OT

Provider Business Mailing Address
First Line	:	13 NOTTINGHAM DR
Second Line	:
City	:	LINCOLNSHIRE
State	:	IL
Zip	:	60069-3216
Country	:	US
Telephone Number	:	847-903-6295
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 S MILWAUKEE AVE
Second Line	:	SUITE 201
City	:	LAKE VILLA
State	:	IL
Zip	:	60046-9471
Country	:	US
Telephone Number	:	847-265-3491
Fax Number	:

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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