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Organization
OCCUPATIONAL THERAPY PROVIDERS INC.
Active
Organization
OCCUPATIONAL THERAPY PROVIDERS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUBASHIR ALI KHAN (CEO)
(708) 229-9828
Entity
Organization
Contact information
Practice address
3849 W 95TH STREET, EVERGREEN PARK, IL 60805
(708) 229-9030
(708) 229-9032
Mailing address
3849 W 95TH STREET, EVERGREEN PARK, IL 60805
(708) 229-9828
(708) 422-0914
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634341
BCBS
IL
01
—
611354400
OWCP DEPT OF LABOR
IL
Enumeration date
02/12/2007
Last updated
03/28/2013
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