Provider Demographics
NPI:1457497323
Name:BACHELDER, KRISTI VECELLIO (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:VECELLIO
Last Name:BACHELDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FOREST PRESERVE DR
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-1983
Mailing Address - Country:US
Mailing Address - Phone:802-359-3405
Mailing Address - Fax:
Practice Address - Street 1:400 FOREST PRESERVE DR
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1983
Practice Address - Country:US
Practice Address - Phone:802-359-3405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072-0000414225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist