Provider Demographics
NPI:1710219092
Name:AUSTIN, EMILY ANN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:CHOURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2300 N CHILDRENS PLZ
Mailing Address - Street 2:BOX 142
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3363
Mailing Address - Country:US
Mailing Address - Phone:773-327-2880
Mailing Address - Fax:773-327-0547
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:BOX 142
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-327-2880
Practice Address - Fax:773-327-0547
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.007232225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics