Healthcare Provider Details

I. General information

NPI: 1720291230
Provider Name (Legal Business Name): FATIMA K HUSAIN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22042 W PLYMOUTH CIR
PLAINFIELD IL
60544-7084
US

IV. Provider business mailing address

7401 ALMA DR APT 1034
PLANO TX
75025-3545
US

V. Phone/Fax

Practice location:
  • Phone: 630-254-7576
  • Fax:
Mailing address:
  • Phone: 469-241-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056007470
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: