Basic Information
| Provider Information | |||||||||
| NPI: | 1730401639 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAK | ||||||||
| FirstName: | JAN-LOK | ||||||||
| MiddleName: | DEBORAH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 W FRONTAGE RD | ||||||||
| Address2: | |||||||||
| City: | NORTHFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600931202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474415593 | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 JAMESTOWN LN | ||||||||
| Address2: | |||||||||
| City: | LINCOLNSHIRE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600692119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478839010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2010 | ||||||||
| LastUpdateDate: | 09/07/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 056007079 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.