Provider Demographics
NPI:1972783561
Name:MOHAN, ANNE D (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:D
Last Name:MOHAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2591 COMPASS RD
Mailing Address - Street 2:SUIT 100
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8043
Mailing Address - Country:US
Mailing Address - Phone:847-729-6220
Mailing Address - Fax:847-729-1116
Practice Address - Street 1:2591 COMPASS RD
Practice Address - Street 2:SUIT 100
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8043
Practice Address - Country:US
Practice Address - Phone:847-729-6220
Practice Address - Fax:847-729-1116
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1617235OtherBCBS