Provider Demographics
NPI:1700858982
Name:MEKALA, SHARMILA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SHARMILA
Middle Name:
Last Name:MEKALA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:SHARMILA
Other - Middle Name:
Other - Last Name:GOPALAKRISHNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:626 LAKESIDE KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049-2347
Mailing Address - Country:US
Mailing Address - Phone:217-532-3199
Mailing Address - Fax:217-532-3199
Practice Address - Street 1:1200 E TREMONT ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049-1912
Practice Address - Country:US
Practice Address - Phone:217-532-6111
Practice Address - Fax:217-532-2726
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL370661208006Medicaid