Christine Gliwa

Individual provider Active NPI Occupational Therapy Assistant · Dwight, IL

NPI 1801205653 · NPPES record last updated Aug 6, 2014

Key facts

NPI
1801205653
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057000172 (IL)
Practice address
110 Karen Dr
Dwight, IL 60420-1600
Phone
(815) 584-4324
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
Yes

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
057000172ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057000172 IL Yes

Addresses

Primary practice location

110 Karen Dr
Dwight, IL 60420-1600

Mailing address

110 Karen Dr
Dwight, IL 60420-1600
Phone (815) 584-4324

Other providers in Dwight, IL

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

Sources for this page

Verify at the official NPI Registry.