Provider Demographics
NPI:1952440471
Name:SZUKIS, ANGELA L (MOT,OTRL)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:L
Last Name:SZUKIS
Suffix:
Gender:F
Credentials:MOT,OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15507 S ROUTE 59 STE 1
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2724
Mailing Address - Country:US
Mailing Address - Phone:815-267-3844
Mailing Address - Fax:815-267-3855
Practice Address - Street 1:15507 S ROUTE 59 STE 1
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2724
Practice Address - Country:US
Practice Address - Phone:815-267-3844
Practice Address - Fax:815-267-3855
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics