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General NPI Number Information
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NPI Number | 1538486972
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Entity Type | Individual
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Provider Name | JESSICA SYLVIA WHEELER M.S., OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 2225 ENTERPRISE DR STE 2505
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City | WESTCHESTER
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State | IL
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Zip | 60154-5805
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Country | US
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Telephone | 470-809-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 2616 N HAMPDEN CT APT 101
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City | CHICAGO
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State | IL
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Zip | 60614-1732
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Country | US
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Telephone | 773-817-0473
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056007574
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License Number State | IL
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