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NPI Code Detail

MEDICARE: MONIQUE HARDEN OTR/L

MEDICARE: MONIQUE HARDEN 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 Therapist056004823IL

General Provider Information

NPI Number : 1730426743
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE HARDEN OTR/L
Provider Business Mailing Address
First Line : 12536 S PAULINA
Second Line :
City : CALUMET PARK
State : IL
Zip : 60827
Country : US
Telephone Number : 773-209-1315
Fax Number :
Provider Business Practice Location Address
First Line : 4314 S WABASH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60653-3119
Country : US
Telephone Number : 773-286-1382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2013
Last Update Date : 01/10/2013

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Directions to “ MONIQUE HARDEN OTR/L” Practice Location

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