Basic Information
| Provider Information | |||||||||
| NPI: | 1811184104 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUDSON | ||||||||
| FirstName: | KARLA | ||||||||
| MiddleName: | SUE | ||||||||
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| Credential: | MHS, OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4394 CENTRAL AVE | ||||||||
| Address2: | UNIT A | ||||||||
| City: | WESTERN SPRINGS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605581383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7088297676 | ||||||||
| FaxNumber: | 7084963422 | ||||||||
| Practice Location | |||||||||
| Address1: | 6500 W 65TH ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606384962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084961515 | ||||||||
| FaxNumber: | 7084963422 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2007 | ||||||||
| LastUpdateDate: | 10/01/2007 | ||||||||
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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 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.