Healthcare Provider Details

I. General information

NPI: 1700254067
Provider Name (Legal Business Name): ARIEL WALUKONIS MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26156 N ACORN LN
MUNDELEIN IL
60060-4071
US

IV. Provider business mailing address

602 DAWES ST
LIBERTYVILLE IL
60048-3106
US

V. Phone/Fax

Practice location:
  • Phone: 847-566-9221
  • Fax:
Mailing address:
  • Phone: 847-305-9589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056011156
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: