Provider Demographics
NPI:1659611267
Name:TATE, REMONA (OT)
Entity Type:Individual
Prefix:MS
First Name:REMONA
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7354 S WHIPPLE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-3046
Mailing Address - Country:US
Mailing Address - Phone:773-218-6543
Mailing Address - Fax:
Practice Address - Street 1:7354 S WHIPPLE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-3046
Practice Address - Country:US
Practice Address - Phone:773-218-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist