Provider Demographics
NPI:1427181874
Name:ABELENDA, ALEJANDRA (OT)
Entity Type:Individual
Prefix:MS
First Name:ALEJANDRA
Middle Name:
Last Name:ABELENDA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 N. LASALLE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6005
Mailing Address - Country:US
Mailing Address - Phone:312-943-3600
Mailing Address - Fax:312-943-7901
Practice Address - Street 1:1620 N. LASALLE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6005
Practice Address - Country:US
Practice Address - Phone:312-943-3600
Practice Address - Fax:312-943-7901
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL56006788225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL103034Medicaid
IL147715Medicare ID - Type Unspecified