Provider Demographics
NPI:1841440153
Name:ROZIN-LEVIN, OLGA (OT)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:ROZIN-LEVIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:1832 WENTZVILLE PKWY
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3817
Practice Address - Country:US
Practice Address - Phone:636-327-7110
Practice Address - Fax:636-327-7135
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999141568225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO150900012Medicare PIN
MO532400002Medicare PIN
MO151100012Medicare PIN