Provider Demographics
NPI:1831354364
Name:DHANENS, KAREN ANN (OTR L)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:DHANENS
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 EAST 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:COAL VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61240
Mailing Address - Country:US
Mailing Address - Phone:309-799-5064
Mailing Address - Fax:309-799-5464
Practice Address - Street 1:1108 EAST 4TH STREET
Practice Address - Street 2:
Practice Address - City:COAL VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61240
Practice Address - Country:US
Practice Address - Phone:309-799-5064
Practice Address - Fax:309-799-5464
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056000570225X00000X
IA00601225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist