Provider Demographics
NPI:1225103658
Name:ZINE, DONNA JEAN (OTRL)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:ZINE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-3007
Mailing Address - Country:US
Mailing Address - Phone:630-844-1110
Mailing Address - Fax:630-264-6906
Practice Address - Street 1:725 GRAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-3007
Practice Address - Country:US
Practice Address - Phone:630-844-1110
Practice Address - Fax:630-264-6906
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
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