Provider Demographics
NPI:1750524096
Name:MCFARLAND, MINDY RENEE (MOT)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:RENEE
Last Name:MCFARLAND
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:RENEE
Other - Last Name:BIETHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 ELEVEN S STE 1B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-1078
Practice Address - Country:US
Practice Address - Phone:618-281-9699
Practice Address - Fax:618-281-9698
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 225XP0200X
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist