Provider Demographics
NPI:1194060111
Name:LANKE, ERIN (OT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LANKE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 W BELMONT AVE APT 1502
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4631
Mailing Address - Country:US
Mailing Address - Phone:414-526-1785
Mailing Address - Fax:
Practice Address - Street 1:510 W BELMONT AVE APT 1502
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4631
Practice Address - Country:US
Practice Address - Phone:414-526-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056009785225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist