Provider Demographics
NPI:1992833842
Name:SCALISE, MEGHAN FRANCINE (MS OTRL)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:FRANCINE
Last Name:SCALISE
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 W CORNELIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3304
Mailing Address - Country:US
Mailing Address - Phone:312-961-7315
Mailing Address - Fax:866-725-5119
Practice Address - Street 1:505 N LAKE SHORE DR
Practice Address - Street 2:SUITE 214
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3427
Practice Address - Country:US
Practice Address - Phone:312-288-8748
Practice Address - Fax:866-725-5119
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-006257225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist