Lymphatic Wellness Clinic

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

LYMPHATIC WELLNESS CLINIC

Practice address

120 S Madison Ave
La Grange, IL 60525-2340

Phone

(708) 328-8594

NPI assigned

Jan 20, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra Wallin, OT

Title

Managing Member/Owner

Phone

(708) 328-8594

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1134719479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S MADISON AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MADISON AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252340",
            "telephone_number": "708-328-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYMPHATIC WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "WALLIN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "MANAGING MEMBER/OWNER",
        "authorized_official_telephone_number": "708-328-8594",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Patrice Love, LSW
• Leah Lowery, FNP-BC
• Sean Lowitz, DO
• Beth Lukaszewicz, RDN
• Mariana Luna, M.A
• Anjali Jain Lyons, MSW, LCSW
• Shannon E Lyons, CCC-SLP
• Aileen Lysaught, M.S. CCC-SLP/L
• Meggan Macfarlane, LCSW
• Meera Mahajan, D.D.S.,M.S.

• Occupational Therapist in La Grange, IL
• Providers in La Grange, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.