Provider Demographics
NPI:1407295868
Name:GELINE, EMILY MARGARET (OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARGARET
Last Name:GELINE
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 1:1436 W RANDOLPH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1405
Mailing Address - Country:US
Mailing Address - Phone:312-733-0883
Mailing Address - Fax:
Practice Address - Street 1:1436 W RANDOLPH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1405
Practice Address - Country:US
Practice Address - Phone:312-733-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.010176225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist