Healthcare Provider Details

I. General information

NPI: 1386745164
Provider Name (Legal Business Name): WILLIAM C. HELLYER JR. MBA, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 S ALPINE RD
ROCKFORD IL
61109-2604
US

IV. Provider business mailing address

5002 TELLURIDE CT
CALEDONIA IL
61011-9006
US

V. Phone/Fax

Practice location:
  • Phone: 815-874-8000
  • Fax: 815-874-7525
Mailing address:
  • Phone: 815-979-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: