Provider Demographics
NPI:1629758917
Name:KUMAR, ARJUN GIRISH (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:ARJUN
Middle Name:GIRISH
Last Name:KUMAR
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 HAVERSHAM DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-7045
Mailing Address - Country:US
Mailing Address - Phone:630-881-4709
Mailing Address - Fax:
Practice Address - Street 1:3140 FINLEY RD STE 400D
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1376
Practice Address - Country:US
Practice Address - Phone:331-775-2813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015541225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist