Mary Alice Keith, OTR/L
Individual provider Active NPI Occupational Therapist · Chatham, IL
NPI 1124378799 · NPPES record last updated Sep 11, 2012
Key facts
- NPI
- 1124378799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056000571 (IL)
- Practice address
- 805 E. Spruce
Chatham, IL 62692 - Phone
- (217) 483-4643
- NPI assigned
- Sep 11, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056000571 | IL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056000571 | IL | Yes |
Addresses
Primary practice location
805 E. Spruce
Chatham, IL 62692
Mailing address
805 E. Spruce
Chatham, IL 62692
Other providers in Chatham, IL
- Jones Chiropractic SC
- Michael Robert Jones
- Crystal Lynn Jordan
- Bethany Racheal Jose
- Paige Kater
- Julianna Kessler
- Rhonda Lorene Klasinski
- Lauren D Lawson
- Margaret Mackenzie Lee
- Timothy C Lonergan
All providers in Chatham, IL · Occupational Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.