Provider Demographics
NPI:1659594422
Name:WEYRICH, LYNN (OT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:WEYRICH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 WHITEWATER LN
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-7564
Mailing Address - Country:US
Mailing Address - Phone:630-551-0642
Mailing Address - Fax:
Practice Address - Street 1:823 129TH INFANTRY DR
Practice Address - Street 2:SUITE 104
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8346
Practice Address - Country:US
Practice Address - Phone:815-729-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand