Basic Information
Provider Information
NPI: 1467912725
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LYNCH
FirstName: CLARE
MiddleName: M
NamePrefix:  
NameSuffix: I
Credential: MSOT, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 950 LEE ST STE 210
Address2:  
City: DES PLAINES
State: IL
PostalCode: 600166574
CountryCode: US
TelephoneNumber: 8774864140
FaxNumber:  
Practice Location
Address1: 1308 WAUKEGAN RD STE 103
Address2:  
City: GLENVIEW
State: IL
PostalCode: 600253070
CountryCode: US
TelephoneNumber: 8474864140
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/22/2019
LastUpdateDate: 03/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X056.012977ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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