Provider Demographics
NPI:1578224531
Name:WASKO, ALEXANDRA NICOLE (OTD, OTR/L)
Entity Type:Individual
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First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:WASKO
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Gender:F
Credentials:OTD, OTR/L
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Mailing Address - Street 1:11914 ILLINOIS ROUTE 59
Mailing Address - Street 2:SUITE 134
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585
Mailing Address - Country:US
Mailing Address - Phone:630-381-0496
Mailing Address - Fax:815-676-9090
Practice Address - Street 1:11914 ILLINOIS ROUTE 59
Practice Address - Street 2:SUITE 134
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585
Practice Address - Country:US
Practice Address - Phone:630-381-0496
Practice Address - Fax:815-676-9090
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-04-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist