Healthcare Provider Details

I. General information

NPI: 1619871654
Provider Name (Legal Business Name): JOYFUL SPROUTS OCCUPATIONAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4036 PICARDY DR
NORTHBROOK IL
60062-2122
US

IV. Provider business mailing address

4036 PICARDY DR
NORTHBROOK IL
60062-2122
US

V. Phone/Fax

Practice location:
  • Phone: 312-768-8123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: YU ZHAO
Title or Position: OTR/L
Credential: OTR/L
Phone: 312-768-8123