Individual
MS. LAURA M HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
8911 OLCOTT AVE, MORTON GROVE, IL 60053
(847) 687-8367
Mailing address
8911 OLCOTT AVE, MORTON GROVE, IL 60053
(847) 687-8367
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1635004
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
03/15/2007
Last updated
07/08/2007
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