Provider Demographics
NPI:1154439883
Name:WOO, JULIE ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:WOO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:SPAULDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:830 S ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2877
Mailing Address - Country:US
Mailing Address - Phone:630-620-4433
Mailing Address - Fax:630-620-1148
Practice Address - Street 1:799 S MCLEAN BLVD UNIT 103
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-6711
Practice Address - Country:US
Practice Address - Phone:847-742-3264
Practice Address - Fax:847-742-9436
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-006992225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK21706Medicare ID - Type UnspecifiedOCCUPATIONAL THERAPY