Healthcare Provider Details

I. General information

NPI: 1841121514
Provider Name (Legal Business Name): PAIGE ALEXIS OLIVER MOT, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N COUNTY FARM RD
WHEATON IL
60187-3908
US

IV. Provider business mailing address

524 GLENN DR
NEW LENOX IL
60451-3911
US

V. Phone/Fax

Practice location:
  • Phone: 630-407-6500
  • Fax:
Mailing address:
  • Phone: 815-546-9291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.027023
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: