Jesica Nicole Feldman, OTA/L

Individual provider Active NPI Occupational Therapy Assistant · Gillespie, IL

NPI 1033780911 · NPPES record last updated Jul 1, 2021

Key facts

NPI
1033780911
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057.004714 (IL)
Practice address
401 Charles St
Gillespie, IL 62033-1814
Phone
(217) 271-7023
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
057.004714ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.004714 IL Yes

Addresses

Primary practice location

401 Charles St
Gillespie, IL 62033-1814

Mailing address

401 Charles St
Gillespie, IL 62033-1814
Phone (217) 271-7023

Other providers in Gillespie, IL

All providers in Gillespie, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.