Healthcare Provider Details

I. General information

NPI: 1225232044
Provider Name (Legal Business Name): JULIE EBOHON EHIZEMWOGIE LEVEL 2 BEHAVIOR THE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE EBOHON UIWA OCCUPATIONAL THERAPI

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CORNERSTONE SERVICES INC 777 JOYCE ROAD
JOLIET IL
60436
US

IV. Provider business mailing address

CORNERSTONE SERVICES INC 777 JOYCE ROAD
JOLIET IL
60436
US

V. Phone/Fax

Practice location:
  • Phone: 773-574-4730
  • Fax: 815-744-6916
Mailing address:
  • Phone: 773-574-4730
  • Fax: 815-744-6916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number006210
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: