Provider Demographics
NPI:1508310004
Name:OLENEK, MICHELLE (MSOT, OTR/L, BCP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:OLENEK
Suffix:
Gender:F
Credentials:MSOT, OTR/L, BCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 MACOM DR STE 103
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9360
Mailing Address - Country:US
Mailing Address - Phone:630-585-7337
Mailing Address - Fax:
Practice Address - Street 1:1315 MACOM DR STE 103
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9360
Practice Address - Country:US
Practice Address - Phone:630-585-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.011607225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist