Provider Demographics
NPI:1467117887
Name:CUCURAS, EVANGELIA KYRIAKOS (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:EVANGELIA
Middle Name:KYRIAKOS
Last Name:CUCURAS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4535 CLEARWATER LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-6135
Mailing Address - Country:US
Mailing Address - Phone:630-770-7347
Mailing Address - Fax:
Practice Address - Street 1:1101 31ST ST STE 110
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5562
Practice Address - Country:US
Practice Address - Phone:630-929-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.014547225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILQME921584518OtherBLUECROSS BLUESHIELD OF ILLINOIS