Nicole D Bray, OTRL
Individual provider Active NPI Occupational Therapist · Mokena, IL
NPI 1922147248 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922147248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 19065 Hickory Creek Dr
#110
Mokena, IL 60448 - Phone
- (708) 478-5400
- Fax
- (708) 478-5300
- NPI assigned
- Feb 5, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 056007593 | IL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | IL | Yes |
Addresses
Primary practice location
19065 Hickory Creek Dr
#110
Mokena, IL 60448
Mailing address
1720 Conventry Rd
New Lenox, IL 60451
Phone (815) 922-0986
Other providers in Mokena, IL
- Kerry Bouck
- Kathryn Boudouris
- Tara Boyles
- Braden Partners LP
- Rachel Michelle Brauer Dever
- Irene Bresingham
- Bright Path Residential Services Inc.
- Bright Stride Mental Health, PLLC
- Joseph Anthony Brisbois
- Skye Brouwer
All providers in Mokena, 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.