Provider Demographics
NPI:1972718955
Name:SANCHEZ, MIKIA ALEDA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MIKIA
Middle Name:ALEDA
Last Name:SANCHEZ
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 1:2947 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-1639
Mailing Address - Country:US
Mailing Address - Phone:773-719-5921
Mailing Address - Fax:773-435-6710
Practice Address - Street 1:2947 W 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1639
Practice Address - Country:US
Practice Address - Phone:773-719-5921
Practice Address - Fax:773-435-6710
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056007652225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist