Provider Demographics
NPI:1205502150
Name:HARRER, ALEXANDRA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:HARRER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:HARRER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:106 N WILMETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1731
Mailing Address - Country:US
Mailing Address - Phone:630-222-4264
Mailing Address - Fax:
Practice Address - Street 1:1619 N MILL ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2858
Practice Address - Country:US
Practice Address - Phone:630-778-3475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.014217225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist