Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 056.004405 | IL |
NPI | 1023331857 |
---|---|
Provider Name | Mrs. Jennifer B Rifis-Meng |
First Address | Highland Park, IL 60035-2433 |
Second Address | Highland Park, IL 60035-2433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2010 |
Last Update Date | 08/03/2010 |