Provider Demographics
NPI:1114148095
Name:OBREGON-GRECO, ROSA (OTR L)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:
Last Name:OBREGON-GRECO
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 HUEHL RD
Mailing Address - Street 2:BUILDING 14A
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2319
Mailing Address - Country:US
Mailing Address - Phone:847-412-9772
Mailing Address - Fax:847-412-9773
Practice Address - Street 1:425 HUEHL RD
Practice Address - Street 2:BUILDING 14A
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2319
Practice Address - Country:US
Practice Address - Phone:847-412-9772
Practice Address - Fax:847-412-9773
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics