Provider Demographics
NPI:1275967572
Name:THOMAS, MEGAN K (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 STONEHAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8409
Mailing Address - Country:US
Mailing Address - Phone:630-585-0552
Mailing Address - Fax:630-429-9411
Practice Address - Street 1:1288 STONEHAVEN CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8409
Practice Address - Country:US
Practice Address - Phone:630-585-0552
Practice Address - Fax:630-429-9411
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.008914225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist