MEDICARE: ANGELINA GILL 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	OT013492	OH

General Provider Information

NPI Number	:	1962975391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELINA GILL OTR/L

Provider Business Mailing Address
First Line	:	7147 N JESTER PL
Second Line	:
City	:	CONCORD TWP
State	:	OH
Zip	:	44077-9540
Country	:	US
Telephone Number	:	440-812-1787
Fax Number	:

Provider Business Practice Location Address
First Line	:	6810 CORK COLD SPRINGS RD
Second Line	:
City	:	GENEVA
State	:	OH
Zip	:	44041-9346
Country	:	US
Telephone Number	:	440-466-1278
Fax Number	:

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

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	09/25/2025

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