Healthcare Provider Details

I. General information

NPI: 1407583412
Provider Name (Legal Business Name): LAUREN FERRENDELLI OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN HINTZMAN OTD, OTR/L

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W LAKE ST STE 108
ELMHURST IL
60126-1419
US

IV. Provider business mailing address

4900 FOREST AVE APT 302
DOWNERS GROVE IL
60515-3516
US

V. Phone/Fax

Practice location:
  • Phone: 331-209-0047
  • Fax:
Mailing address:
  • Phone: 847-708-4627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.015020
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: