Basic Information
Provider Information
NPI: 1558533042
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HWANG
FirstName: CATHERINE
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2700 W BELMONT AVE
Address2: 504
City: CHICAGO
State: IL
PostalCode: 606185983
CountryCode: US
TelephoneNumber: 8477228350
FaxNumber:  
Practice Location
Address1: 3703 W LAKE AVE
Address2: SUITE 200
City: GLENVIEW
State: IL
PostalCode: 600265823
CountryCode: US
TelephoneNumber: 8479981188
FaxNumber: 8479988008
Other Information
ProviderEnumerationDate: 03/25/2008
LastUpdateDate: 03/25/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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