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Individual

JACQUELINE CAROL CUMMINGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-1000
Mailing address
2922 ASHTON CT, WESTCHESTER, IL 60154-5611
(219) 331-0849

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010438
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056010438
ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
31005631A
PROFESSIONAL LICENSING AGENCY OF INDIANA
IN
Enumeration date
03/16/2015
Last updated
03/16/2015
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