Provider Demographics
NPI:1477519981
Name:FROEMMING, LIANNE (OT)
Entity Type:Individual
Prefix:
First Name:LIANNE
Middle Name:
Last Name:FROEMMING
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LIANNE
Other - Middle Name:
Other - Last Name:RAASCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:1290 N SUMMIT AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4459
Practice Address - Country:US
Practice Address - Phone:262-468-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3832225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40483900Medicaid
WIQ38954Medicare UPIN
WI0002Medicare ID - Type Unspecified