Provider Demographics
NPI:1114092657
Name:ROSSETTI, RENEE ANN (OTR L)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:ANN
Last Name:ROSSETTI
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:MRS
Other - First Name:RENEE
Other - Middle Name:ANN
Other - Last Name:FEIGLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR L
Mailing Address - Street 1:2300 N CHILDRENS PLZ
Mailing Address - Street 2:BOX 142
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3363
Mailing Address - Country:US
Mailing Address - Phone:773-327-2880
Mailing Address - Fax:
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:BOX 142
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-327-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics