Provider Demographics
NPI:1952333585
Name:LENZ, SHARI B (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:B
Last Name:LENZ
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:M
Other - Last Name:BURGGRAF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:2940 N LAKEWOOD AVE
Mailing Address - Street 2:#6
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4155
Mailing Address - Country:US
Mailing Address - Phone:312-848-4201
Mailing Address - Fax:866-382-3721
Practice Address - Street 1:2940 N LAKEWOOD AVE
Practice Address - Street 2:#6
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4155
Practice Address - Country:US
Practice Address - Phone:312-848-4201
Practice Address - Fax:866-382-3721
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056004923225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics