Healthcare Provider Details

I. General information

NPI: 1952417420
Provider Name (Legal Business Name): ELIZABETH T. OSTEN MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETH OSTEN OTR/L

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 TALISMON LN
JOHNSBURG IL
60051-7700
US

IV. Provider business mailing address

3206 TALISMON LN
JOHNSBURG IL
60051-7700
US

V. Phone/Fax

Practice location:
  • Phone: 224-619-5835
  • Fax:
Mailing address:
  • Phone: 224-619-5835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number056000807
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: