Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 05600367 | IL |
NPI | 1033385893 |
---|---|
Provider Name | Karen Erickson |
First Address | South Elgin, IL 60177-3308 |
Second Address | South Elgin, IL 60177-3308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 01/05/2008 |