Provider Demographics
NPI:1497326417
Name:ELLIS, CHLOE ROPIAK (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CHLOE
Middle Name:ROPIAK
Last Name:ELLIS
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 1:2N451 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1734
Mailing Address - Country:US
Mailing Address - Phone:630-390-6521
Mailing Address - Fax:
Practice Address - Street 1:2N451 WOODCREST DR
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-1734
Practice Address - Country:US
Practice Address - Phone:630-390-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056014261225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist