Healthcare Provider Details

I. General information

NPI: 1225712466
Provider Name (Legal Business Name): JOYFUL OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 BAYOU PATH DR
NAPERVILLE IL
60563-3498
US

IV. Provider business mailing address

1468 BAYOU PATH DR
NAPERVILLE IL
60563-3498
US

V. Phone/Fax

Practice location:
  • Phone: 847-769-0689
  • Fax:
Mailing address:
  • Phone: 847-769-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BHUMI BHATT
Title or Position: OWNER
Credential:
Phone: 847-769-0689