Provider Demographics
NPI:1649578873
Name:O'BRIEN, PATRICIA (OTR/L)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N HOYNE AVE
Mailing Address - Street 2:UNIT 2S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1361
Mailing Address - Country:US
Mailing Address - Phone:773-383-6996
Mailing Address - Fax:
Practice Address - Street 1:2211 N OAK PARK AVE
Practice Address - Street 2:REHABILITATION DEPARTMENT
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-3351
Practice Address - Country:US
Practice Address - Phone:773-385-5874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113094225X00000X
IL056006774225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist