Provider Demographics
NPI:1841498979
Name:OCCUPATIONAL & HAND THERAPY, LTD.
Entity type:Organization
Organization Name:OCCUPATIONAL & HAND THERAPY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:YAGER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:708-403-0010
Mailing Address - Street 1:12757 WESTERN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BLUE ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60406-2155
Mailing Address - Country:US
Mailing Address - Phone:708-388-0003
Mailing Address - Fax:708-388-2888
Practice Address - Street 1:12757 WESTERN AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:BLUE ISLAND
Practice Address - State:IL
Practice Address - Zip Code:60406-2155
Practice Address - Country:US
Practice Address - Phone:708-388-0003
Practice Address - Fax:708-388-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0280090002Medicare NSC
IL795510Medicare UPIN