Provider Demographics
NPI:1053997163
Name:PRIZANT, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PRIZANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 RIENZI LN
Mailing Address - Street 2:
Mailing Address - City:HIGHWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60040-2022
Mailing Address - Country:US
Mailing Address - Phone:847-780-8139
Mailing Address - Fax:
Practice Address - Street 1:697 RIENZI LN
Practice Address - Street 2:
Practice Address - City:HIGHWOOD
Practice Address - State:IL
Practice Address - Zip Code:60040-2022
Practice Address - Country:US
Practice Address - Phone:847-334-4538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist