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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

FANOR BENAVIDEZ

Active Sole Proprietor

FANOR BENAVIDEZ is a Occupational Therapy Assistant healthcare provider located in LA GRANGE, Illinois. NPI 1316793011 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapy Assistant · LA GRANGE, IL

Registration Details

NPI Number
1316793011
Provider Type
Individual
Gender
Male
NPI Issued
Apr 24, 2024 (2.3348301573829 yrs)
Last Updated
Apr 24, 2024
License
057.005735 (IL)
Sole Proprietor
Yes

Practice Information

Address
35 SHAWMUT AVE
LA GRANGE, IL, 605258648
Browse IL providers · Browse ZIP 60525
Phone
7082069899
Primary Specialty
Occupational Therapy Assistant
224Z00000X

Other Occupational Therapy Assistant Providers in LA GRANGE, IL

Name Credential NPI
MRS. CASSANDRA DENISE GILL COTA/L 1003183351
ALICIA THOMAS 1750766010
JOAN WELCH COTA 1679004055
MRS. KRISTEN THERESA BURKE 1508489907
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.