Malorie Defore
Individual provider Active NPI Occupational Therapist · Mendota, IL
NPI 1992390843 · NPPES record last updated Mar 3, 2021
Key facts
- NPI
- 1992390843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056014108 (IL)
- Practice address
- 1205 Indiana Ave
Mendota, IL 61342-1650 - Phone
- (815) 414-1136
- NPI assigned
- Mar 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
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)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Therapeutics LTD | Occupational Therapist | Current |
Accepting new patients |
| Comprehensive Therapeutics LTD | Occupational Therapist | Current |
Accepting new patients |
Locations
1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056014108 | IL | Yes |
Addresses
Primary practice location
1205 Indiana Ave
Mendota, IL 61342-1650
Mailing address
1205 Indiana Ave
Mendota, IL 61342-1650
Other providers in Mendota, IL
- Neungja Chung
- City of Mendota
- Community Health Partnership of Illinois
- Davis Family Health LLC
- Kelly Ann Tonielli Davis
- Peter Doran
- Paul Daniel Doyle
- Dr. Megan'S Healthcare Ministries LLC
- Franklin J Duro
- Hannah Eager
All providers in Mendota, 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 Mar 3, 2021. 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.