Provider Demographics
NPI:1295942076
Name:ROBINSON, MARLA RAE (OTRL)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:RAE
Last Name:ROBINSON
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 1:1458 W BELLE PLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1902
Mailing Address - Country:US
Mailing Address - Phone:773-248-9026
Mailing Address - Fax:773-702-5340
Practice Address - Street 1:5841 S MARYLAND AVE # MC1081
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-0576
Practice Address - Fax:773-702-5340
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
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