Provider Demographics
NPI:1073744397
Name:PAYTON, AMY JANE (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JANE
Last Name:PAYTON
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 1:1847 VASSAR DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-9261
Mailing Address - Country:US
Mailing Address - Phone:630-428-2399
Mailing Address - Fax:
Practice Address - Street 1:1847 VASSAR DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-9261
Practice Address - Country:US
Practice Address - Phone:630-428-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.003855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist