Individual
MRS. PEGGY LYNN LEVERSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3818 JUNIPER AVE, JOLIET, IL 60431-2787
(815) 347-2181
Mailing address
3818 JUNIPER AVE, JOLIET, IL 60431-2787
(815) 347-2181
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-000324
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056-000324
DEPT. OF PROFESSION REGULATION
IL
Enumeration date
07/21/2011
Last updated
07/21/2011
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