Provider Demographics
NPI:1326559402
Name:WRIGHT, GAIL ANN (COTA/L)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:ANN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-3412
Mailing Address - Country:US
Mailing Address - Phone:708-755-4642
Mailing Address - Fax:
Practice Address - Street 1:30 W 16TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-3412
Practice Address - Country:US
Practice Address - Phone:708-755-4642
Practice Address - Fax:708-756-4841
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant