Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 056009419 | IL |
NPI | 1841538097 |
---|---|
Provider Name | Pamela Ann Hart |
First Address | Glenview, IL 60025 |
Second Address | Glenview, IL 60025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2013 |
Last Update Date | 23/01/2013 |