Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 056008569 | IL |
NPI | 1396027587 |
---|---|
Provider Name | Ms. Tracy Ann Schnabel |
First Address | Oak Lawn, IL 60453 |
Second Address | Oak Lawn, IL 60453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2011 |
Last Update Date | 17/08/2021 |