Provider Demographics
NPI:1881042299
Name:HOBUS, NICOLE THERESE (MS,OTR/L)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:THERESE
Last Name:HOBUS
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:THERESE
Other - Last Name:BIELECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6216 S NATCHEZ AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-4216
Mailing Address - Country:US
Mailing Address - Phone:773-592-8937
Mailing Address - Fax:
Practice Address - Street 1:6216 S NATCHEZ AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-4216
Practice Address - Country:US
Practice Address - Phone:773-592-8937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056010215225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics