Bonita Marie Doellman, M.A. OTRL
Individual provider Active NPI Occupational Therapist · Quincy, IL
NPI 1457477259 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457477259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 911 Summit Dr
Quincy, IL 62305-1353 - Phone
- (217) 224-3259
- Fax
- (217) 224-3259
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01523 | IA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Physical Therapy & Sports Medicine LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 005107 | MO | |
| Occupational Therapist | 225X00000X | 01523 | IA | |
| Occupational Therapist | 225X00000X | IL | Yes |
Addresses
Primary practice location
911 Summit Dr
Quincy, IL 62305-1353
Mailing address
911 Summit Dr
Quincy, IL 62305-1353
Phone (217) 224-3259
Other providers in Quincy, IL
- Jean A. Disseler
- William H Dixon
- Mary I Dobbins
- Kimberly Dochterman
- Christopher Doedtman
- Mary Straub Doellman
- Donald a. Busbey D.D.S. Prof. Corp.
- Randi N. Donaldson
- Gianfranco Dongo
- Thomas S Donovan
All providers in Quincy, IL · Occupational Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.