Provider Demographics
NPI:1760371850
Name:THURMAN, MAKIYAH
Entity type:Individual
Prefix:
First Name:MAKIYAH
Middle Name:
Last Name:THURMAN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 184TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2769
Mailing Address - Country:US
Mailing Address - Phone:708-527-4664
Mailing Address - Fax:
Practice Address - Street 1:3025 SPRING LAKE DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-4403
Practice Address - Country:US
Practice Address - Phone:708-474-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.015208225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist