Jordan Aleece Gehrig, COTA

Individual provider Active NPI Occupational Therapy Assistant · Monmouth, IL

NPI 1609560952 · NPPES record last updated Aug 6, 2023

Key facts

NPI
1609560952
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057006017 (IL)
Practice address
117 S I St
Monmouth, IL 61462-1544
Phone
(309) 734-3811
NPI assigned
Jun 7, 2023
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
057006017ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057006017 IL Yes

Addresses

Primary practice location

117 S I St
Monmouth, IL 61462-1544

Mailing address

1497 N Town Ave
Princeville, IL 61559-9782
Phone (309) 863-0601

Other practice location 1

2600 Compass Rd
Glenview, IL 60026-8001
Phone (877) 787-3430

Other providers in Monmouth, IL

All providers in Monmouth, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.