Basic Information
| Provider Information | |||||||||
| NPI: | 1811193832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAGGINS | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | OTRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4806 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606804806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3125190990 | ||||||||
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| Practice Location | |||||||||
| Address1: | 815 E IRVING PARK RD | ||||||||
| Address2: | |||||||||
| City: | STREAMWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601073073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308375300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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.