Provider Demographics
NPI:1306275888
Name:SCHERGEN, GINA NICOLE (MS-OTR/L)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:NICOLE
Last Name:SCHERGEN
Suffix:
Gender:F
Credentials:MS-OTR/L
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:NICOLE
Other - Last Name:LOCOCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS-OTR/L
Mailing Address - Street 1:100 W PLAINFIELD RD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COUNTRYSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60525
Mailing Address - Country:US
Mailing Address - Phone:708-588-0833
Mailing Address - Fax:708-588-0406
Practice Address - Street 1:100 W PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:COUNTRYSIDE
Practice Address - State:IL
Practice Address - Zip Code:60525-2869
Practice Address - Country:US
Practice Address - Phone:708-588-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056010344225X00000X
IL056-010344225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist