MEDICARE: MISS JOANN J PREKEZES MS OTRL

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	056-006503	IL

General Provider Information

NPI Number	:	1841343829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JOANN J PREKEZES MS OTRL

Provider Business Mailing Address
First Line	:	4445 W IRVING PARK RD STE 300
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2808
Country	:	US
Telephone Number	:	630-933-1500
Fax Number	:	630-933-1550

Provider Business Practice Location Address
First Line	:	4445 W IRVING PARK RD STE 300
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2808
Country	:	US
Telephone Number	:	630-933-1500
Fax Number	:	630-933-1550

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

Provider Enumeration Date	:	01/21/2007
Last Update Date	:	12/06/2024

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