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General NPI Number Information
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NPI Number | 1336674688
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Entity Type | Individual
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Provider Name | STEPHANIE RUTH BEDAHL BUJAK OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 2630 BRIAR TRL APT 104
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City | SCHAUMBURG
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State | IL
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Zip | 60173-5571
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Country | US
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Telephone | 320-280-0774
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Fax |
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Provider Business Mailing Address
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Address Line | 527 SPRING ST
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City | BATAVIA
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State | IL
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Zip | 60510-2157
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056011782
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License Number State | IL
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