Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 056004870 | IL |
N | 225XH1200X | Occupational Therapist - Hand | 056004870 | IL |
NPI | 1124314422 |
---|---|
Provider Name | Deanna L Vasiliauskas |
First Address | Chicago, IL 60674-0001 |
Second Address | Wheaton, IL 60187-5529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2011 |
Last Update Date | 09/09/2021 |