Individual
MS. JENNIFER N LAWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
303 N. WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 676-5045
Mailing address
303 N. WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 676-5045
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007945
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00991698
RR MEDICARE
IL
Enumeration date
01/26/2007
Last updated
01/27/2012
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