Provider Demographics
NPI:1407135932
Name:SOLIK, GRACE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:
Last Name:SOLIK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:SOLIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:4616 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1507
Mailing Address - Country:US
Mailing Address - Phone:708-246-3661
Mailing Address - Fax:
Practice Address - Street 1:1048 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2894
Practice Address - Country:US
Practice Address - Phone:630-810-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.005954225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics