Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 56002607 | IL |
N | 225XH1200X | Occupational Therapist - Hand | 056-002607 | IL |
NPI | 1265553218 |
---|---|
Provider Name | Lynette Marie Rajterowski |
First Address | Sycamore, IL 60178-3175 |
Second Address | Sycamore, IL 60178-2703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 17/03/2018 |