Provider Demographics
NPI:1700910940
Name:ZIEGLER, ELLEN M (MS,OTR, CHT)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:MS,OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 BERNICE DR
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-3366
Mailing Address - Country:US
Mailing Address - Phone:630-350-2736
Mailing Address - Fax:630-350-2842
Practice Address - Street 1:143 BERNICE DR
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-3366
Practice Address - Country:US
Practice Address - Phone:630-350-2736
Practice Address - Fax:630-350-2842
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL588560Medicare ID - Type Unspecified