Allison Gonzalez, OT

Individual provider Active NPI Occupational Therapist · La Grange, IL

NPI 1982809000 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1982809000
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
56007952 (IL)
Practice address
4735 Willow Springs Rd
La Grange, IL 60525-6130
Phone
(708) 352-6900
NPI assigned
Jun 19, 2007
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
56007952ILMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 56007952 IL Yes

Addresses

Primary practice location

4735 Willow Springs Rd
La Grange, IL 60525-6130

Mailing address

115 Saint Thomas Way
Covington, LA 70433-1532
Phone (504) 481-9800

Other providers in La Grange, IL

All providers in La Grange, IL · Occupational Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.