Provider Demographics
NPI:1891080073
Name:KARIM, MARILYN PORTER (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:PORTER
Last Name:KARIM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 POLO DR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4656
Mailing Address - Country:US
Mailing Address - Phone:630-267-5028
Mailing Address - Fax:
Practice Address - Street 1:612 POLO DR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4656
Practice Address - Country:US
Practice Address - Phone:630-267-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-000009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist