Individual
MRS. AMANDA ROSENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
100 W PLAINFIELD RD, COUNTRYSIDE, IL 60525-2869
(708) 588-0833
Mailing address
17818 OAK PARK AVE, APT 2S, TINLEY PARK, IL 60477-3964
(708) 570-4033
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.008632
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3942809Y
—
IL
Enumeration date
06/17/2009
Last updated
06/17/2009
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