Individual
IAN ITANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
(708) 555-5555
Mailing address
SELECT REHABILITATION, 2600 COMPASS RD, GLENVIEW, IL 60026
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004519
IL
224Z00000X
Occupational Therapy Assistant
—
—
Other
Enumeration date
03/16/2021
Last updated
03/21/2021
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