Provider Demographics
NPI:1346611613
Name:ESSINK, KATHERINE (OT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ESSINK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:
Practice Address - Street 1:1312 W ARCH HAVEN AVE
Practice Address - Street 2:BLDG1320, STE E
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2089
Practice Address - Country:US
Practice Address - Phone:812-336-8406
Practice Address - Fax:812-336-8342
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005976A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist