Individual
KATI ECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
105 W A ST, BELLEVILLE, IL 62220-1326
(618) 234-4294
Mailing address
413 W MADISON ST, O FALLON, IL 62269-1180
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007572
IL
225X00000X
Occupational Therapist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467590166
—
IL
Enumeration date
09/02/2006
Last updated
11/17/2017
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