Healthcare Provider Details

I. General information

NPI: 1538287933
Provider Name (Legal Business Name): JULIE C CHENEY OCCUP THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N LOGAN ST
DEER CREEK IL
61733-9358
US

IV. Provider business mailing address

405 N LOGAN ST
DEER CREEK IL
61733-9358
US

V. Phone/Fax

Practice location:
  • Phone: 309-264-4573
  • Fax:
Mailing address:
  • Phone: 309-264-4573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056-005771
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: