Provider Demographics
NPI:1750609079
Name:HOOYENGA, KATHY (OTR/L , ATP, RET)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:
Last Name:HOOYENGA
Suffix:
Gender:F
Credentials:OTR/L , ATP, RET
Other - Prefix:
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Mailing Address - Street 1:1640 W ROOSEVELT RD
Mailing Address - Street 2:RM 415
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1316
Mailing Address - Country:US
Mailing Address - Phone:312-996-3196
Mailing Address - Fax:312-413-3709
Practice Address - Street 1:1640 W ROOSEVELT RD
Practice Address - Street 2:RM 415
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1316
Practice Address - Country:US
Practice Address - Phone:312-996-3196
Practice Address - Fax:312-413-3709
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL056.003142225XE0001X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation