Individual
HEIDI GROSNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
403 E 1ST ST, DIXON, IL 61021-3116
(815) 285-5531
(815) 285-5592
Mailing address
646 2ND AVE, DIXON, IL 61021-1914
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008140
IL
225X00000X
Occupational Therapist
8090-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056.008140
STATE OF ILLINOIS OT LICENSE
IL
01
—
8090-26
STATE LICENSE
WI
Enumeration date
02/10/2023
Last updated
02/10/2023
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