Provider Demographics
NPI:1639663974
Name:PATEL, TRINA E (OTR/L)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:E
Last Name:PATEL
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 1:439 SUNDANCE DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-5092
Mailing Address - Country:US
Mailing Address - Phone:847-220-2848
Mailing Address - Fax:
Practice Address - Street 1:1936 BROOKDALE RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2015
Practice Address - Country:US
Practice Address - Phone:630-548-4604
Practice Address - Fax:630-548-4605
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
IL056.011661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist