Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | IL |
NPI | 1053459115 |
---|---|
Provider Name | Kimberly Zemanek |
First Address | Lockport, IL 60441-6023 |
Second Address | Darien, IL 60561-5281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |