Provider Demographics
NPI:1619145489
Name:BABULA, ALISON (OTR)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:BABULA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:GERNHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:1100 S CHRISTOPHER COLUMBUS BLVD
Practice Address - Street 2:STE 25
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-5513
Practice Address - Country:US
Practice Address - Phone:267-592-4508
Practice Address - Fax:215-467-2408
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014911225X00000X
PAOC012882225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist