Provider Demographics
NPI:1184002297
Name:OHASHI, KOJI (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:KOJI
Middle Name:
Last Name:OHASHI
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 DUNLEER DR.
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060
Mailing Address - Country:US
Mailing Address - Phone:224-715-1107
Mailing Address - Fax:
Practice Address - Street 1:901 BIESTERFIELD RD. STE 211
Practice Address - Street 2:MARIA A. CASTELLESE D.C., P.C.
Practice Address - City:ELK GROVE
Practice Address - State:IL
Practice Address - Zip Code:60007
Practice Address - Country:US
Practice Address - Phone:847-690-9492
Practice Address - Fax:847-357-9181
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.003507225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist