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NPI Code Detail

MEDICARE: CORBIN REILLY BOWEN OTR/L

MEDICARE: CORBIN REILLY BOWEN 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 Therapist056.016234IL

General Provider Information

NPI Number : 1851128524
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORBIN REILLY BOWEN OTR/L
Provider Business Mailing Address
First Line : 424 E OAKWOOD BLVD UNIT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60653-2328
Country : US
Telephone Number : 312-513-9887
Fax Number :
Provider Business Practice Location Address
First Line : 2320 E 93RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60617-3909
Country : US
Telephone Number : 773-967-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2024
Last Update Date : 04/07/2026

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Directions to “ CORBIN REILLY BOWEN OTR/L” Practice Location

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