Provider Demographics
NPI:1497943724
Name:GOLDIE, ANDREA L (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:GOLDIE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:L
Other - Last Name:BEERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:227 SPRINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-8476
Mailing Address - Country:US
Mailing Address - Phone:773-930-5958
Mailing Address - Fax:847-468-1756
Practice Address - Street 1:227 SPRINGSIDE DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-8476
Practice Address - Country:US
Practice Address - Phone:773-930-5958
Practice Address - Fax:847-468-1756
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.007717225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics