Anwar Adams, OT

Individual provider Active NPI Occupational Therapist · Forest Park, IL

NPI 1174857262 · NPPES record last updated Aug 8, 2019

Key facts

NPI
1174857262
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
056012069 (IL)
Practice address
1029 Des Plaines Ave Apt 601
Forest Park, IL 60130
Phone
(847) 630-8640
NPI assigned
Sep 23, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2057193ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2057193 IL
Occupational Therapist 225X00000X 056012069 IL Yes

Addresses

Primary practice location

1029 Des Plaines Ave Apt 601
Forest Park, IL 60130

Mailing address

4101 S Michigan Ave Apt 305
Chicago, IL 60653-2144
Phone (847) 630-8640

Other practice location 1

1405 Holland
Houston, TX 77029
Phone (888) 429-2875

Other providers in Forest Park, IL

All providers in Forest Park, IL · Occupational Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.