Provider Demographics
NPI:1184983314
Name:KEUNING, TENA (OTR/L)
Entity type:Individual
Prefix:
First Name:TENA
Middle Name:
Last Name:KEUNING
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 1:4422 N GREENVIEW AVE
Mailing Address - Street 2:3E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5925
Mailing Address - Country:US
Mailing Address - Phone:312-714-9733
Mailing Address - Fax:
Practice Address - Street 1:4422 N GREENVIEW AVE
Practice Address - Street 2:3E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5925
Practice Address - Country:US
Practice Address - Phone:312-714-9733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009110225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist