Basic Information
| Provider Information | |||||||||
| NPI: | 1972044451 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRAFT | ||||||||
| FirstName: | EMILY | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5051 N GLENWOOD AVE APT 2J | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606406804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3198839875 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16600 W SPRAGUE RD | ||||||||
| Address2: | SUITE 365 | ||||||||
| City: | MIDDLEBURG HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441306318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162277700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2017 | ||||||||
| LastUpdateDate: | 03/16/2017 | ||||||||
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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 | 224Z00000X | 057004679 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.