Angela Adams

Individual provider Active NPI Occupational Therapist · Peoria, IL

NPI 1124564802 · NPPES record last updated Jan 18, 2017

Key facts

NPI
1124564802
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
056009112 (IL)
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2381
NPI assigned
Jan 18, 2017
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

LicenseStateTypeSpecialty
056009112ILMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056009112 IL Yes

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2381

Other providers in Peoria, IL

All providers in Peoria, IL · Occupational Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.