4619 N. Ravenswood Ave. Suite 204 Chicago, Il 60640

Organization Active NPI Occupational Therapy Assistant · Chicago, IL

NPI 1992481246 · NPPES record last updated Jun 22, 2023

Key facts

NPI
1992481246
Entity type
Organization (NPI type 2)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Legal business name
4619 N. RAVENSWOOD AVE. SUITE 204 CHICAGO, IL 60640
Practice address
4619 N Ravenswood Ave Ste 204
Chicago, IL 60640-4579
Phone
(773) 697-7333
NPI assigned
Jun 22, 2023
Organization subpart
No

Authorized official

Name
Maya Elena E Horowitz, COTA/L
Title
Occupational Therapy Assistant
Phone
(773) 797-4155

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
224Z00000X Yes

Addresses

Primary practice location

4619 N Ravenswood Ave Ste 204
Chicago, IL 60640-4579

Mailing address

4619 N Ravenswood Ave Ste 204
Chicago, IL 60640-4579

Other providers in Chicago, IL

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

Sources for this page

Verify at the official NPI Registry.