Provider Demographics
NPI:1982839304
Name:GRIFFIN, MONICA D (OTD, OTR/L, C/NDT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:D
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:OTD, OTR/L, C/NDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 N KING CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2781
Mailing Address - Country:US
Mailing Address - Phone:224-578-5785
Mailing Address - Fax:
Practice Address - Street 1:1129 N KING CHARLES CT
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2781
Practice Address - Country:US
Practice Address - Phone:224-578-5785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056008480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist