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Individual

NITA MOHANAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3965 75TH ST, SUITE 104, AURORA, IL 60504-7925
(630) 236-7000
Mailing address
1967 CLARENDON LN, AURORA, IL 60504-4861
(847) 997-9965

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.011316
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056011316
LICENSE
IL
Enumeration date
09/01/2016
Last updated
09/01/2016
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