Provider Demographics
NPI:1437464989
Name:POLLARI, ELSIE HURTADO (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ELSIE
Middle Name:HURTADO
Last Name:POLLARI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:ELSIE
Other - Middle Name:
Other - Last Name:HURTADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 W MONROE ST
Mailing Address - Street 2:#421
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2413
Mailing Address - Country:US
Mailing Address - Phone:847-682-3796
Mailing Address - Fax:
Practice Address - Street 1:9649 W 55TH ST
Practice Address - Street 2:
Practice Address - City:COUNTRYSIDE
Practice Address - State:IL
Practice Address - Zip Code:60525-3632
Practice Address - Country:US
Practice Address - Phone:708-352-3580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056009003225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist