Provider Demographics
NPI:1073373320
Name:REDMOND, ALEXA LEIGH (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:LEIGH
Last Name:REDMOND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 ARLINGTON LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-2868
Mailing Address - Country:US
Mailing Address - Phone:224-629-9674
Mailing Address - Fax:
Practice Address - Street 1:1625 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3769
Practice Address - Country:US
Practice Address - Phone:847-725-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056015945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist