Provider Demographics
NPI:1437395795
Name:PRASHANT, PREETI (OTR/L)
Entity type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:PRASHANT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103
Mailing Address - Country:US
Mailing Address - Phone:312-890-8472
Mailing Address - Fax:
Practice Address - Street 1:1091 HORIZON DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-1246
Practice Address - Country:US
Practice Address - Phone:312-890-8472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.005436225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist