Provider Demographics
NPI:1922573401
Name:NAVARRO, JOSE MANUEL JR (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:MANUEL
Last Name:NAVARRO
Suffix:JR
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 S 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-2608
Mailing Address - Country:US
Mailing Address - Phone:630-202-0475
Mailing Address - Fax:
Practice Address - Street 1:800 W OAKTON ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4602
Practice Address - Country:US
Practice Address - Phone:847-368-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.005009224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant