Provider Demographics
NPI:1801122338
Name:LOWREY, ELLEN MICHELLE (OTR)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:MICHELLE
Last Name:LOWREY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:MICHELLE
Other - Last Name:GREENWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2000 E ALGONQUIN RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4189
Mailing Address - Country:US
Mailing Address - Phone:847-303-5790
Mailing Address - Fax:847-303-5795
Practice Address - Street 1:2000 E ALGONQUIN RD
Practice Address - Street 2:SUITE 109
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4189
Practice Address - Country:US
Practice Address - Phone:847-303-5790
Practice Address - Fax:847-303-5795
Is Sole Proprietor?:No
Enumeration Date:2009-10-17
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056007118225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL202845063Medicare PIN
IL211585016Medicare PIN
IL216859030Medicare UPIN