Provider Demographics
NPI:1134287725
Name:BLAIR, JOY ELLEN (MS OTRL)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:ELLEN
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:MRS
Other - First Name:JOY
Other - Middle Name:E
Other - Last Name:HERSHEY BLAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS OTRL
Mailing Address - Street 1:606 BARTON AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2111
Mailing Address - Country:US
Mailing Address - Phone:847-869-6594
Mailing Address - Fax:847-869-5438
Practice Address - Street 1:8833 GROSS POINT RD
Practice Address - Street 2:SUITE 308
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1859
Practice Address - Country:US
Practice Address - Phone:847-674-2630
Practice Address - Fax:847-674-4042
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist