Provider Demographics
NPI:1912064544
Name:KLINGER, TERESE ANN (MOT)
Entity Type:Individual
Prefix:
First Name:TERESE
Middle Name:ANN
Last Name:KLINGER
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 N HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2224
Mailing Address - Country:US
Mailing Address - Phone:708-691-0097
Mailing Address - Fax:630-832-2645
Practice Address - Street 1:366 N HIGHVIEW AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2224
Practice Address - Country:US
Practice Address - Phone:708-691-0097
Practice Address - Fax:630-832-2645
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL56007186225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist