Kathy L Reynolds

Individual provider Active NPI Occupational Therapy Assistant · Odin, IL

NPI 1700435757 · NPPES record last updated Sep 11, 2019

Key facts

NPI
1700435757
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057002836 (IL)
Practice address
300 Green St
Odin, IL 62870-1062
Phone
(618) 775-6444
NPI assigned
Sep 11, 2019
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
057002836ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057002836 IL Yes

Addresses

Primary practice location

300 Green St
Odin, IL 62870-1062

Mailing address

300 Green St
Odin, IL 62870-1062

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address kbheinzmann@savasc.com Health Information Exchange (HIE)

Other providers in Odin, IL

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

Sources for this page

Verify at the official NPI Registry.