Provider Demographics
NPI:1942976816
Name:HUNTER, JUSTIN (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 N MILWAUKEE AVE UNIT 416
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2061
Mailing Address - Country:US
Mailing Address - Phone:630-258-6142
Mailing Address - Fax:
Practice Address - Street 1:3233 W ADDISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4328
Practice Address - Country:US
Practice Address - Phone:773-478-0496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist