Provider Demographics
NPI:1174678635
Name:DILLON, LINDA R (OTR)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:DILLON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:K
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:3701 BELLEMEADE AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0137
Mailing Address - Country:US
Mailing Address - Phone:812-479-1411
Mailing Address - Fax:812-437-2636
Practice Address - Street 1:3701 BELLEMEADE AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0137
Practice Address - Country:US
Practice Address - Phone:812-479-1411
Practice Address - Fax:812-437-2636
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000269A225X00000X, 225XE1200X, 225XH1200X, 225XH1300X, 225XN1300X, 225XP0200X, 225XR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistDriving and Community Mobility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200892870Medicaid
IN000000512037OtherANTHEM PIN