Provider Demographics
NPI:1023320041
Name:SCHENK, ROSANNE S (OT)
Entity type:Individual
Prefix:
First Name:ROSANNE
Middle Name:S
Last Name:SCHENK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ROSANNE
Other - Middle Name:S
Other - Last Name:LUCAS SCHENK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:1500 WAUKEGAN RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2100
Mailing Address - Country:US
Mailing Address - Phone:847-657-9445
Mailing Address - Fax:847-657-9450
Practice Address - Street 1:1500 WAUKEGAN RD
Practice Address - Street 2:SUITE 250
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2100
Practice Address - Country:US
Practice Address - Phone:847-657-9445
Practice Address - Fax:847-657-9450
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-003963225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist