Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003231648 |
---|---|
Provider Name | Elizabeth Kosek |
First Address | Downers Grove, IL 60515-1335 |
Second Address | Schiller Park, IL 60176-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2014 |
Last Update Date | 15/04/2020 |