Provider Demographics
NPI:1518206218
Name:LOUIS, HEATHER MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:LOUIS
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 1:21406 ENGLISH DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2282
Mailing Address - Country:US
Mailing Address - Phone:708-307-3612
Mailing Address - Fax:
Practice Address - Street 1:6601 171ST ST
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-3514
Practice Address - Country:US
Practice Address - Phone:708-614-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005426A225XP0200X
IL056010016225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics