Provider Demographics
NPI:1477293066
Name:MYERS, LORI ANN (DOTR/L)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:MYERS
Suffix:
Gender:F
Credentials:DOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3572 W LYNDALE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3644
Mailing Address - Country:US
Mailing Address - Phone:773-531-5913
Mailing Address - Fax:
Practice Address - Street 1:1952 MCDOWELL RD
Practice Address - Street 2:SUITE 207
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:630-922-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056012951225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist