MEDICARE: JENNY MARY THOMAS 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
1	225X00000X	Occupational Therapist	056010054	IL

General Provider Information

NPI Number	:	1760273494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY MARY THOMAS OTR/L

Provider Business Mailing Address
First Line	:	305 W VICTORIA LN
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3759
Country	:	US
Telephone Number	:	847-302-7385
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 W VICTORIA LN
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3759
Country	:	US
Telephone Number	:	847-302-7385
Fax Number	:

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

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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