Provider Demographics
NPI:1508377680
Name:SAYLOR, AMANDA LYNN (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:SAYLOR
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 1:77 N WOLF RD UNIT 207
Mailing Address - Street 2:
Mailing Address - City:NORTHLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60164-1640
Mailing Address - Country:US
Mailing Address - Phone:630-607-9991
Mailing Address - Fax:
Practice Address - Street 1:55 S GREELEY ST
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-6174
Practice Address - Country:US
Practice Address - Phone:847-686-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056012173225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist