Provider Demographics
NPI:1083865489
Name:FERRETTI, JULIE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FERRETTI
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 N LOOMIS ST
Mailing Address - Street 2:UNIT 3K
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 N LOOMIS ST
Practice Address - Street 2:UNIT 3K
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1914
Practice Address - Country:US
Practice Address - Phone:314-805-7275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-008160225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics