Provider Demographics
NPI:1487974069
Name:BUFORD-HINES, ARLENE (MOTR/L)
Entity type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:
Last Name:BUFORD-HINES
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11161 S LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4005
Mailing Address - Country:US
Mailing Address - Phone:773-779-9350
Mailing Address - Fax:773-779-9840
Practice Address - Street 1:901 S AUSTIN BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-5311
Practice Address - Country:US
Practice Address - Phone:773-287-9181
Practice Address - Fax:773-921-4232
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.007510225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist