Pamela Dianne Jackson OTR/L

NPI 1083041123 - Occupational Therapist - 225X00000X

NPI Details
NPI 1083041123
Gender Female
Enumeration Date 10/03/2013
Last Updated 10/03/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
5400 W 87TH ST
BURBANK IL, 60459-2913, US
Phone (708) 346-6236
Fax
Business Location
5400 WEST 87TH STREET
BURBANK IL, 60459, US
Phone (708) 346-6236
Fax
Toxanomy
Taxonomy Code 225X00000X
License State Illinois
License Number 056001722
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According to our database, Mrs. Pamela Dianne Jackson OTR/L NPI is 1083041123, taxonomy code is 225X00000X and license number is 056001722, license state is located at Illinois. Pamela Dianne Jackson OTR/L physically located at 5400 W 87th St, Burbank IL, 60459-2913. NPI Number Pamela Dianne Jackson OTR/L has the Individual type.

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1083041123 NPI number is provided on an as is basis without warranty of any kind. 1083041123 is maintained by the National Plan & Provider Enumeration System. The contents of Pamela Dianne Jackson OTR/L are for informational purposes only.