Provider Demographics
NPI:1861183824
Name:SHAPIRO, RUTH D (OTR)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:D
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E SOUTH WATER ST APT 2101
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4062
Mailing Address - Country:US
Mailing Address - Phone:925-788-7866
Mailing Address - Fax:
Practice Address - Street 1:5333 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7371
Practice Address - Country:US
Practice Address - Phone:847-864-1936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015406225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist