Provider Demographics
NPI:1528180288
Name:DRUEN, MONICA LEA (OTRL)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LEA
Last Name:DRUEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LEA
Other - Last Name:GALLENTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:1316 WATERS CT
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-2629
Mailing Address - Country:US
Mailing Address - Phone:815-285-5830
Mailing Address - Fax:
Practice Address - Street 1:403 E 1ST ST
Practice Address - Street 2:KSB HOSPITAL
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-3116
Practice Address - Country:US
Practice Address - Phone:815-285-5830
Practice Address - Fax:815-285-5592
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist