Provider Demographics
NPI:1740324458
Name:WILSON, ANNE LUCIA (MS OTR L)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:LUCIA
Last Name:WILSON
Suffix:
Gender:F
Credentials:MS OTR L
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:LUCIA
Other - Last Name:ACCETTURO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1545 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062
Mailing Address - Country:US
Mailing Address - Phone:847-205-2201
Mailing Address - Fax:
Practice Address - Street 1:1545 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-205-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist