Provider Demographics
NPI:1295465599
Name:HOAK, GRACE (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:HOAK
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 E OHIO ST UNIT 3809
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5875
Mailing Address - Country:US
Mailing Address - Phone:847-274-7659
Mailing Address - Fax:
Practice Address - Street 1:355 E OHIO ST UNIT 3809
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5875
Practice Address - Country:US
Practice Address - Phone:847-274-7659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.014911225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist