Provider Demographics
NPI:1770099533
Name:YU, JAMIE (MOT OTR/L)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:MOT OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 WEHRMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SCHILLER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60176-1814
Mailing Address - Country:US
Mailing Address - Phone:847-671-0250
Mailing Address - Fax:847-671-0256
Practice Address - Street 1:3945 WEHRMAN AVE
Practice Address - Street 2:
Practice Address - City:SCHILLER PARK
Practice Address - State:IL
Practice Address - Zip Code:60176-1814
Practice Address - Country:US
Practice Address - Phone:847-671-0250
Practice Address - Fax:847-671-0256
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
IL056.014750225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics