Healthcare Provider Details

I. General information

NPI: 1255256830
Provider Name (Legal Business Name): LINDSAY NICOLE CONDON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17709 E COLONIAL CT
PLAINFIELD IL
60586
US

IV. Provider business mailing address

17709 E COLONIAL CT
PLAINFIELD IL
60586
US

V. Phone/Fax

Practice location:
  • Phone: 815-278-1679
  • Fax:
Mailing address:
  • Phone: 815-278-1679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT29290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: