Provider Demographics
NPI:1982837746
Name:MALAVIA, SONAL CHETAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:SONAL
Middle Name:CHETAN
Last Name:MALAVIA
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 1:997 CHADWICK CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9325
Mailing Address - Country:US
Mailing Address - Phone:847-690-1914
Mailing Address - Fax:
Practice Address - Street 1:200 W MARTIN AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6516
Practice Address - Country:US
Practice Address - Phone:630-355-4111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056004700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist