Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 056-005605 | IL |
NPI | 1235241506 |
---|---|
Provider Name | Mrs. Catherine Ann Ringer |
First Address | Bolingbrook, IL 60440-4909 |
Second Address | Chicago, IL 60643-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 19/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1632204 | BLUE CROSS/BLUE SHIELD (01) | IL |