Michael Cernivec, OTR/L

Individual provider Active NPI Hand Occupational Therapist · Fox River Grove, IL

NPI 1306403076 · NPPES record last updated May 28, 2019

Key facts

NPI
1306403076
Entity type
Individual (NPI type 1)
Primary specialty
Hand Occupational Therapist 225XH1200X
License
056.012880 (IL)
Practice address
1009 State Route 22
Fox River Grove, IL 60021-1998
Phone
(847) 462-8707
NPI assigned
May 28, 2019
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

State licenses

LicenseStateTypeSpecialty
056.012880ILMDHand Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225XH1200X 056.012880 IL Yes

Addresses

Primary practice location

1009 State Route 22
Fox River Grove, IL 60021-1998

Mailing address

730 Beacon Dr
Lake Barrington, IL 60010-1577

Other names

  • Michael Cernivec Professional name

Other providers in Fox River Grove, IL

All providers in Fox River Grove, IL · Hand Occupational Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.