Provider Demographics
NPI:1518553916
Name:GARCIA, KRISTA JILL (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:JILL
Last Name:GARCIA
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 1:1144 W 17TH ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2479
Mailing Address - Country:US
Mailing Address - Phone:815-535-6691
Mailing Address - Fax:
Practice Address - Street 1:1144 W 17TH ST APT 1R
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2479
Practice Address - Country:US
Practice Address - Phone:815-535-6691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist