Provider Demographics
NPI:1184391419
Name:CERNY, GRACE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:CERNY
Suffix:
Gender:F
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 1:676 WESTFIELD CRSE
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3441
Mailing Address - Country:US
Mailing Address - Phone:630-254-9559
Mailing Address - Fax:
Practice Address - Street 1:2901 FINLEY RD STE 102
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1774
Practice Address - Country:US
Practice Address - Phone:630-495-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056014410225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist