Willie J Blair, OT
Individual provider Active NPI Occupational Therapist · Richton Park, IL
NPI 1669780276 · NPPES record last updated Sep 16, 2010
Key facts
- NPI
- 1669780276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056004034 (IL)
- Practice address
- 5026 Capri LN
Richton Park, IL 60471-1193 - Phone
- (877) 974-6383
- NPI assigned
- Sep 16, 2010
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 056004034 | IL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056004034 | IL | Yes |
Addresses
Primary practice location
5026 Capri LN
Richton Park, IL 60471-1193
Mailing address
5026 Capri LN
Richton Park, IL 60471-1193
Other providers in Richton Park, IL
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- Titilayo Ayeni-Sode
- Beauty, Fyne, & Fitness
- Bja Consultants LLC
- Dena Blackman
- Dorothy A. Bliss
- Carlthel Brent
- Brightlife Counseling LLC
- Barbara Brooks
- Cynthia Brooks
All providers in Richton Park, 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 Sep 16, 2010. 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.