Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 056.009627 | IL |
NPI | 1336415223 |
---|---|
Provider Name | Megha Sharma |
First Address | West Chicago, IL 60185 |
Second Address | West Chicago, IL 60185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 26/03/2012 |