Provider Demographics
NPI:1851667240
Name:KRAHN, AMY KATHLYN (OTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:KATHLYN
Last Name:KRAHN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:150 FOREST AVE
Mailing Address - Street 2:UNIT 1615
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1297
Mailing Address - Country:US
Mailing Address - Phone:805-405-0466
Mailing Address - Fax:
Practice Address - Street 1:150 FOREST AVE
Practice Address - Street 2:UNIT 1615
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1297
Practice Address - Country:US
Practice Address - Phone:805-405-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.010772225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist