Provider Demographics
NPI:1437894292
Name:SAUNDERS, ASHLEY (OTD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 S JUGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:IL
Mailing Address - Zip Code:60424-5908
Mailing Address - Country:US
Mailing Address - Phone:815-514-8877
Mailing Address - Fax:
Practice Address - Street 1:510 BROADWAY
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3762
Practice Address - Country:US
Practice Address - Phone:309-452-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.014780225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation