Provider Demographics
NPI:1073638532
Name:FURMAN, LAURA ANN (OT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:FURMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6624 N CLARK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4036
Mailing Address - Country:US
Mailing Address - Phone:773-895-3477
Mailing Address - Fax:773-338-3005
Practice Address - Street 1:6624 N CLARK ST APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-4036
Practice Address - Country:US
Practice Address - Phone:773-895-3477
Practice Address - Fax:773-338-3005
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist