Provider Demographics
NPI:1881404556
Name:KOKKINIAS, PENELOPE A (MOT)
Entity type:Individual
Prefix:MRS
First Name:PENELOPE
Middle Name:A
Last Name:KOKKINIAS
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:MS
Other - First Name:PENELOPE
Other - Middle Name:A
Other - Last Name:LEVENTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:2419 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4822
Mailing Address - Country:US
Mailing Address - Phone:847-751-0389
Mailing Address - Fax:
Practice Address - Street 1:2419 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4822
Practice Address - Country:US
Practice Address - Phone:847-751-0389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056014716225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist