Amy Lynn Bolelli, OTR/L
Individual provider Active NPI Occupational Therapist · Peru, IL
NPI 1720311590 · NPPES record last updated Sep 11, 2009
Key facts
- NPI
- 1720311590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056.003539 (IL)
- Practice address
- 310 Walnut St
Peru, IL 61354-1946 - Phone
- (815) 780-3509
- Fax
- (814) 224-6744
- NPI assigned
- Sep 11, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 056.003539 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Margaret'S Health-Peru | Past | Accepting new patients | |
| St. Margaret'S Health-Peru | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.003539 | IL | Yes |
Addresses
Primary practice location
310 Walnut St
Peru, IL 61354-1946
Mailing address
310 Walnut St
Peru, IL 61354-1946
Phone (815) 780-3509
Other providers in Peru, IL
- Kami Lynn Becker
- Angela Benavides
- Alejandro B Bernal
- Sondra L Blocki
- Shyrlena L Bogard
- Joan Elizabeth Boska
- David Bourbonnais
- Nathan Bowers
- David Bernerd Brandner
- Kelsey Janelle Brannan
All providers in Peru, 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 11, 2009. 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.