Basic Information
Provider Information
NPI: 1902550056
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAQVI
FirstName: ALENA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MOT, OTR/L
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 416501
Address2:  
City: BOSTON
State: MA
PostalCode: 022416501
CountryCode: US
TelephoneNumber: 1942944050
FaxNumber:  
Practice Location
Address1: 444 N NORTHWEST HWY STE 147
Address2:  
City: PARK RIDGE
State: IL
PostalCode: 600683263
CountryCode: US
TelephoneNumber: 8477076744
FaxNumber: 8477862156
Other Information
ProviderEnumerationDate: 02/08/2022
LastUpdateDate: 02/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X056.014712ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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