Provider Demographics
NPI:1851670715
Name:CECCHI, KIM M (OTR CHI)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:M
Last Name:CECCHI
Suffix:
Gender:F
Credentials:OTR CHI
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:M
Other - Last Name:SENGLAUB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR CHI
Mailing Address - Street 1:28100 TORCH PKWY
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-4026
Mailing Address - Country:US
Mailing Address - Phone:877-407-3422
Mailing Address - Fax:866-210-1111
Practice Address - Street 1:7 CARNEGIE PLZ
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1000
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:866-210-1111
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3788225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist