Mark D Leverenz, OTR/L
Individual provider Active NPI Occupational Therapist · Golden, IL
NPI 1275726952 · NPPES record last updated Aug 25, 2007
Key facts
- NPI
- 1275726952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 101 Prairie Mills Rd
Golden, IL 62339-1016 - Phone
- (217) 696-4421
- NPI assigned
- Aug 25, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056003842 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caremark Rehab, LTD. | Occupational Therapist | Past | Accepting new patients |
| United Therapy Services, Inc. | Past | Accepting new patients | |
| United Therapy Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | IL | Yes |
Addresses
Primary practice location
101 Prairie Mills Rd
Golden, IL 62339-1016
Mailing address
7411 112TH St
Blue Grass, IA 52726-9121
Phone (563) 343-4735
Other providers in Golden, IL
- Richlyn Laramie Frakes
- Golden Good Shepherd Home
- Amy Graves
- Holly Jo Henderson
- Tracy Lynn Kurfman
- Patricia Ann Steffen
- Laura Tenhouse
All providers in Golden, 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 Aug 25, 2007. 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.