Provider Demographics
NPI:1740152743
Name:NEUHAUS, TALIA ANSON (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:ANSON
Last Name:NEUHAUS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3729 N KEELER AVE APT 3R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3074
Mailing Address - Country:US
Mailing Address - Phone:847-922-5431
Mailing Address - Fax:
Practice Address - Street 1:100 W PLAINFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:COUNTRYSIDE
Practice Address - State:IL
Practice Address - Zip Code:60525-2654
Practice Address - Country:US
Practice Address - Phone:708-588-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.016770225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist