Individual
MRS. GAMINEE PATEL SURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2740 W ARMITAGE AVE, UNIT 403S, CHICAGO, IL 60647-4240
(773) 412-9849
Mailing address
2740 W ARMITAGE AVE, UNIT 403S, CHICAGO, IL 60647-4240
(773) 412-9849
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.006520
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056006520
OT LICENSE
IL
01
—
GP93470606P
EARLY INTERVENTION CREDEN
IL
Enumeration date
05/08/2007
Last updated
11/20/2009
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