Provider Demographics
NPI:1568781151
Name:UMUNNA, JUDITH ISIOMA (OTR/L)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ISIOMA
Last Name:UMUNNA
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 1:863 BENEDETTI DR
Mailing Address - Street 2:APARTMENT 102
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8932
Mailing Address - Country:US
Mailing Address - Phone:312-217-1385
Mailing Address - Fax:
Practice Address - Street 1:863 BENEDETTI DR
Practice Address - Street 2:APARTMENT 102
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8932
Practice Address - Country:US
Practice Address - Phone:312-217-1385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-22
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009044225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist