Provider Demographics
NPI:1053668822
Name:MONTI, ROXANNE ANGELIE (MS,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:ANGELIE
Last Name:MONTI
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 MEADOWSEDGE LN
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-3409
Mailing Address - Country:US
Mailing Address - Phone:847-963-1483
Mailing Address - Fax:
Practice Address - Street 1:55 S GREELEY ST
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-6174
Practice Address - Country:US
Practice Address - Phone:847-963-1483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056008168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist