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

MR. JEFFERSON JAMES MAHINAY LICUP, OTR/L

Active

MR. JEFFERSON JAMES MAHINAY LICUP, OTR/L is a Occupational Therapist healthcare provider located in BOLINGBROOK, Illinois. NPI 1437484110 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · BOLINGBROOK, IL

Registration Details

NPI Number: 1437484110
Provider Type: Individual
Gender: Male
NPI Issued: Oct 13, 2009 (16.693160854012 yrs)
Last Updated: Oct 13, 2009
License: 056007185 (IL)

Practice Information

Address: 226 TIGER ST

BOLINGBROOK, IL, 604902053
Browse IL providers · Browse ZIP 60490
Phone: 7088228886
Fax: 6303784839
Primary Specialty: Occupational Therapist
225X00000X

Other Occupational Therapist Providers in BOLINGBROOK, IL

Name	Credential	NPI
ITIONA M SCOTT	—	1760580963
MRS. JANICE MARIE HAYWOOD	OTRL	1346391810
ANDREA L BATEMAN	OT	1154597714
AUDREY NELSON AROWOLO	OTR	1871745349
MRS. CHRISTINA TINGSON MERCADO	—	1366760399
MARIA ANDREA CEMPRON MONTEJO	—	1154640035

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.