Healthcare Provider Details

I. General information

NPI: 1053537233
Provider Name (Legal Business Name): MANNY OT & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26575 W COMMERCE DR UNIT 506
VOLO IL
60073-9659
US

IV. Provider business mailing address

26575 W COMMERCE DR UNIT 506
VOLO IL
60073-9659
US

V. Phone/Fax

Practice location:
  • Phone: 847-740-6229
  • Fax: 847-740-6447
Mailing address:
  • Phone: 847-740-6229
  • Fax: 847-740-6447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number056005548
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MANUEL HERRERA
Title or Position: OWNER OCCUPATIONAL THERAPIST
Credential: OT
Phone: 847-740-6229