Provider Demographics
NPI:1588945935
Name:MUERSCH-WITTENKELLER, CHRISTINE LYNELL (MS,OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNELL
Last Name:MUERSCH-WITTENKELLER
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 S 81ST AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1912
Mailing Address - Country:US
Mailing Address - Phone:708-903-1732
Mailing Address - Fax:
Practice Address - Street 1:12320 S 81ST AVE
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1912
Practice Address - Country:US
Practice Address - Phone:708-903-1732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056001906225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist