Provider Demographics
NPI:1083830459
Name:ZINNECKER, LORI ANN (OTRL, MBA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:ZINNECKER
Suffix:
Gender:F
Credentials:OTRL, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 W ADDISON ST
Mailing Address - Street 2:#1S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4719
Mailing Address - Country:US
Mailing Address - Phone:773-665-4158
Mailing Address - Fax:
Practice Address - Street 1:539 W ADDISON ST
Practice Address - Street 2:#1S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-4719
Practice Address - Country:US
Practice Address - Phone:773-665-4158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL56001706225X00000X, 225XE1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand