Provider Demographics
NPI:1538508916
Name:BARNES, GAYLE PATRICIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:PATRICIA
Last Name:BARNES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:P
Other - Last Name:EASON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:2223 TETON PKWY
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5434
Mailing Address - Country:US
Mailing Address - Phone:847-533-3672
Mailing Address - Fax:
Practice Address - Street 1:2223 TETON PKWY
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5434
Practice Address - Country:US
Practice Address - Phone:847-533-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490107841041C0700X
IL056003913225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical