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General NPI Number Information
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NPI Number | 1962221465
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Entity Type | Individual
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Provider Name | JESSICA DEVRIES OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 220 N 1ST ST
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City | WHEELING
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State | IL
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Zip | 60090-2980
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Country | US
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Telephone | 847-459-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 600 RED HILL TRL APT 2B
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City | CAROL STREAM
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State | IL
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Zip | 60188-1750
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Country | US
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Telephone | 309-264-3524
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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 | 056.016249
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License Number State | IL
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