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NPI Code Detail

MEDICARE: JESSICA ZYCHOWICZ MOT

MEDICARE:   JESSICA  ZYCHOWICZ  MOT
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
1224Z00000XOccupational Therapy Assistant04207OH
2224Z00000XOccupational Therapy Assistant5202007239MI
3225X00000XOccupational TherapistOT011255OH

General Provider Information

NPI Number : 1881025625
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ZYCHOWICZ MOT
Provider Business Mailing Address
First Line : 600 OAKMONT LN STE 600C
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5548
Country : US
Telephone Number : 630-575-6250
Fax Number : 630-575-7450
Provider Business Practice Location Address
First Line : 4925 JACKMAN RD STE 34
Second Line :
City : TOLEDO
State : OH
Zip : 43613-3557
Country : US
Telephone Number : 567-318-1000
Fax Number : 567-318-1001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2013
Last Update Date : 10/05/2020

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Directions to “ JESSICA ZYCHOWICZ MOT” Practice Location

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