Provider Demographics
NPI:1669639704
Name:SWIFT, MAUREEN C (RN OTR L)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:C
Last Name:SWIFT
Suffix:
Gender:F
Credentials:RN OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 W THORNDALE AVE
Mailing Address - Street 2:UNIT 2 N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3338
Mailing Address - Country:US
Mailing Address - Phone:773-608-0476
Mailing Address - Fax:
Practice Address - Street 1:1450 W THORNDALE AVE
Practice Address - Street 2:UNIT 2N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660
Practice Address - Country:US
Practice Address - Phone:773-608-0476
Practice Address - Fax:773-728-7808
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056001565225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist