Callie Jo Estes

Individual provider Active NPI Occupational Therapy Assistant · Beardstown, IL

NPI 1942957592 · NPPES record last updated Mar 3, 2022

Key facts

NPI
1942957592
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057005741 (IL)
Practice address
8306 Saint Lukes Dr
Beardstown, IL 62618-8384
Phone
(217) 761-7831
NPI assigned
Mar 3, 2022
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

LicenseStateTypeSpecialty
057005741ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057005741 IL Yes

Addresses

Primary practice location

8306 Saint Lukes Dr
Beardstown, IL 62618-8384

Mailing address

2204 Cormorant Dr
Springfield, IL 62711-6213
Phone (217) 761-7831

Other providers in Beardstown, IL

All providers in Beardstown, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.