Healthcare Provider Details

I. General information

NPI: 1245804533
Provider Name (Legal Business Name): ASHLEY MARIE HETTLINGER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY MARIE BUKSA OTR/L

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 11/24/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TURNING WHEELS PEDIATRIC THERAPY 225 ROOSEVELT RD.
WHEATON IL
60187
US

IV. Provider business mailing address

4417 MIDDLETON PL
LISLE IL
60532-5408
US

V. Phone/Fax

Practice location:
  • Phone: 630-200-6972
  • Fax:
Mailing address:
  • Phone: 708-778-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number31007412A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.014137
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: