Provider Demographics
NPI:1801511027
Name:LEARN. PLAY. LIVE. OT, LLC
Entity type:Organization
Organization Name:LEARN. PLAY. LIVE. OT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMANOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:815-326-2337
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:STANDARD
Mailing Address - State:IL
Mailing Address - Zip Code:61363-0163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 7TH ST
Practice Address - Street 2:
Practice Address - City:STANDARD
Practice Address - State:IL
Practice Address - Zip Code:61363-1230
Practice Address - Country:US
Practice Address - Phone:815-326-2337
Practice Address - Fax:833-520-1466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
1649669029OtherNPPES