Provider Demographics
NPI:1245380310
Name:PATTON, JULIA (OT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:M
Other - Last Name:WINDERWEEDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 RAND RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2359
Mailing Address - Country:US
Mailing Address - Phone:847-324-3976
Mailing Address - Fax:847-929-1154
Practice Address - Street 1:1025 RED OAK LN STE 100
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-5017
Practice Address - Country:US
Practice Address - Phone:847-245-7175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-008602225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211458004OtherMEDICARE
IL211459004OtherMEDICARE