Provider Demographics
NPI:1447031000
Name:GREENLEE, VICTORIA ROSE (MOT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ROSE
Last Name:GREENLEE
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-5954
Mailing Address - Country:US
Mailing Address - Phone:330-575-0271
Mailing Address - Fax:
Practice Address - Street 1:719 N MARION STREET
Practice Address - Street 2:OAK PARK
Practice Address - City:60302
Practice Address - State:IL
Practice Address - Zip Code:60302-1530
Practice Address - Country:US
Practice Address - Phone:844-478-6878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics