Provider Demographics
NPI:1093264897
Name:BUARI, PAULA OLUFUNMI
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:OLUFUNMI
Last Name:BUARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:OLUFUNMI
Other - Last Name:BUARI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:700 W FABYAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1269
Mailing Address - Country:US
Mailing Address - Phone:708-691-3527
Mailing Address - Fax:
Practice Address - Street 1:700 W FABYAN PKWY
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1269
Practice Address - Country:US
Practice Address - Phone:708-691-3527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056011664225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist