Provider Demographics
NPI:1578726709
Name:PALERMO, KATHARINE DANIELLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:DANIELLE
Last Name:PALERMO
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 1:2218 COUNTRY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-5780
Mailing Address - Country:US
Mailing Address - Phone:815-272-5117
Mailing Address - Fax:866-615-0768
Practice Address - Street 1:13246 S ROUTE 59
Practice Address - Street 2:SUITE 100
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-9800
Practice Address - Country:US
Practice Address - Phone:815-272-5117
Practice Address - Fax:866-615-0768
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.006126225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932458OtherBLUE CROSS/ BLUE SHIELD PROVIDER NUMBER