Provider Demographics
NPI:1306414271
Name:KOTEVSKI, EMILY KATHERYNE (OTD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KATHERYNE
Last Name:KOTEVSKI
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:KATHERYNE
Other - Last Name:RUDZINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:2124 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7514
Practice Address - Country:US
Practice Address - Phone:630-967-2000
Practice Address - Fax:331-551-5418
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-014322225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist