Provider Demographics
NPI:1457814931
Name:CALAWAY, JESSICA N (OTR)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:N
Last Name:CALAWAY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2456 SHASTA DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2065
Mailing Address - Country:US
Mailing Address - Phone:630-991-8875
Mailing Address - Fax:
Practice Address - Street 1:2456 SHASTA DR
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2065
Practice Address - Country:US
Practice Address - Phone:630-991-8875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist