Provider Demographics
NPI:1528590080
Name:BRENNAN, REBECCA JEAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:BRENNAN
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 1:600 N COMMONS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1864 HIGH GROVE LN STE 122
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9213
Practice Address - Country:US
Practice Address - Phone:708-478-1820
Practice Address - Fax:708-231-7248
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.011920225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics