Healthcare Provider Details

I. General information

NPI: 1528166477
Provider Name (Legal Business Name): CHRISTINA L REASONER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA LYNNE DREYER OTR

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 BROADWAY
MERRILLVILLE IN
46410-7041
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 219-795-3360
  • Fax:
Mailing address:
  • Phone: 630-296-2223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number31003036A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31003036A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: