Provider Demographics
NPI:1558726117
Name:SOLARZ, MONIKA (COTA/L)
Entity Type:Individual
Prefix:PROF
First Name:MONIKA
Middle Name:
Last Name:SOLARZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6959 W HIGGINS AVE UNIT 3W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-1955
Mailing Address - Country:US
Mailing Address - Phone:773-875-6171
Mailing Address - Fax:
Practice Address - Street 1:2801 S LAWNDALE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-4547
Practice Address - Country:US
Practice Address - Phone:773-277-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057004281224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant