Individual
ELENA TASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3703 W LAKE AVE, SUITE 200, GLENVIEW, IL 60026-1223
(847) 998-1188
Mailing address
3703 W LAKE AVE, SUITE 200, GLENVIEW, IL 60026-1223
(847) 998-1188
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
057003240
IL
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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