Provider Demographics
NPI:1013266659
Name:COPE, JULIE LYN
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYN
Last Name:COPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:LYN
Other - Last Name:MILESHOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:581 CARRIAGE WAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4706
Mailing Address - Country:US
Mailing Address - Phone:484-332-3513
Mailing Address - Fax:
Practice Address - Street 1:1901 N. FIFTH STREET
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-1510
Practice Address - Country:US
Practice Address - Phone:717-221-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009599225X00000X
IL056.009302225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist