Provider Demographics
NPI:1962544908
Name:FOUCHIA, ANDREA J (OTRL, MED)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:J
Last Name:FOUCHIA
Suffix:
Gender:F
Credentials:OTRL, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 CLARENCE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2045
Mailing Address - Country:US
Mailing Address - Phone:708-445-1446
Mailing Address - Fax:
Practice Address - Street 1:1165 CLARENCE AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2045
Practice Address - Country:US
Practice Address - Phone:708-445-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics