Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 056.004345 | IL |
NPI | 1205186327 |
---|---|
Provider Name | Victoria Pearlman |
First Address | Evanston, IL 60202-3328 |
Second Address | Evanston, IL 60202-3328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2012 |
Last Update Date | 17/09/2012 |