Provider Demographics
NPI:1609431949
Name:SETTLES, AMANDA JANE
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JANE
Last Name:SETTLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 NE 450 AVE
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:IL
Mailing Address - Zip Code:62016-4453
Mailing Address - Country:US
Mailing Address - Phone:217-248-1435
Mailing Address - Fax:
Practice Address - Street 1:215 HERITAGE MANOR-STAUNTON
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:IL
Practice Address - Zip Code:62088
Practice Address - Country:US
Practice Address - Phone:618-635-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.005182224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant