Provider Demographics
NPI:1912373093
Name:VELLOOKUNNEL, VEENA (MOT)
Entity Type:Individual
Prefix:
First Name:VEENA
Middle Name:
Last Name:VELLOOKUNNEL
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28156 W NORTHPOINTE PKWY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2346
Mailing Address - Country:US
Mailing Address - Phone:224-512-9800
Mailing Address - Fax:224-512-9714
Practice Address - Street 1:28156 W NORTHPOINTE PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2346
Practice Address - Country:US
Practice Address - Phone:224-512-9800
Practice Address - Fax:224-512-9714
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119567225X00000X
IL056-010608225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist