Provider Demographics
NPI:1225576325
Name:SEALS, KAREN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SEALS
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 1:2400 N WAKEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NOBLE
Mailing Address - State:IL
Mailing Address - Zip Code:62868-2553
Mailing Address - Country:US
Mailing Address - Phone:618-838-2234
Mailing Address - Fax:
Practice Address - Street 1:2400 N WAKEFIELD RD
Practice Address - Street 2:
Practice Address - City:NOBLE
Practice Address - State:IL
Practice Address - Zip Code:62868-2553
Practice Address - Country:US
Practice Address - Phone:618-838-2234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056005660225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics