Individual
MRS. JENNIFER L SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
746 CHAMBERS ST, OTTAWA, IL 61350-3954
(815) 431-0706
(815) 431-0706
Mailing address
746 CHAMBERS ST, OTTAWA, IL 61350-3954
(815) 431-0706
(815) 431-0706
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05032030
BCBS PROVIDER NUMBER
IL
Enumeration date
02/03/2007
Last updated
07/08/2007
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