Provider Demographics
NPI:1659799724
Name:PROSKUROVSKY, KAREN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PROSKUROVSKY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 W ALTGELD ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2411
Mailing Address - Country:US
Mailing Address - Phone:517-250-9045
Mailing Address - Fax:
Practice Address - Street 1:2319 N ORCHARD ST
Practice Address - Street 2:CHN
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3303
Practice Address - Country:US
Practice Address - Phone:517-250-9045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.010849225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics