Provider Demographics
NPI:1821525403
Name:ESPEJO-SCHILTZ, MARIA (OT, CCCPA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ESPEJO-SCHILTZ
Suffix:
Gender:F
Credentials:OT, CCCPA
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:D
Other - Last Name:ESPEJO-SCHILTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/CCCPA
Mailing Address - Street 1:3245 GROVE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3476
Mailing Address - Country:US
Mailing Address - Phone:773-947-4607
Mailing Address - Fax:
Practice Address - Street 1:3245 GROVE AVE STE 205
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3476
Practice Address - Country:US
Practice Address - Phone:773-497-4607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies