Provider Demographics
NPI:1336271261
Name:HOTARY, ANNMARIE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:ANNMARIE
Middle Name:
Last Name:HOTARY
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 1:5127 N DAMEN AVE APT A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3558
Mailing Address - Country:US
Mailing Address - Phone:773-294-0790
Mailing Address - Fax:774-944-5784
Practice Address - Street 1:5127 N DAMEN AVE APT A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3558
Practice Address - Country:US
Practice Address - Phone:773-294-0790
Practice Address - Fax:774-944-5784
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056004424225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics