Provider Demographics
NPI:1417117961
Name:MARCOSKI, BEVERLEE J (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:BEVERLEE
Middle Name:J
Last Name:MARCOSKI
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 1:727 BERKSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-4920
Mailing Address - Country:US
Mailing Address - Phone:630-272-7954
Mailing Address - Fax:
Practice Address - Street 1:727 BERKSHIRE CT
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-4920
Practice Address - Country:US
Practice Address - Phone:630-272-7954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.000026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist