Provider Demographics
NPI:1184785032
Name:CUMMINGS, CATHLEEN M (OTRL)
Entity type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:M
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 N LAPORTE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-1529
Mailing Address - Country:US
Mailing Address - Phone:847-990-5805
Mailing Address - Fax:847-573-4201
Practice Address - Street 1:801 S MILWAUKEE AVE
Practice Address - Street 2:DAYHAB
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3204
Practice Address - Country:US
Practice Address - Phone:847-990-5805
Practice Address - Fax:847-573-4201
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist