Individual
COURTNEY E ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
209 N CUMMINGS LN, WASHINGTON, IL 61571-2181
(309) 886-2305
(309) 444-3893
Mailing address
209 N CUMMINGS LN, WASHINGTON, IL 61571-2181
(309) 886-2305
(309) 444-3893
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007895
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00943852
RR MEDICARE
IL
Enumeration date
01/12/2007
Last updated
01/03/2013
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