Provider Demographics
NPI:1134998859
Name:LECHUGA, THALIA (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:THALIA
Middle Name:
Last Name:LECHUGA
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 N KEATING AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3743
Mailing Address - Country:US
Mailing Address - Phone:773-383-2438
Mailing Address - Fax:
Practice Address - Street 1:8707 SKOKIE BLVD STE 402
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2269
Practice Address - Country:US
Practice Address - Phone:847-877-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015846225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics