Provider Demographics
NPI:1780692319
Name:ZARLEY, KRISTY ANNE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:ANNE
Last Name:ZARLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 W NEWPORT AVE
Mailing Address - Street 2:UNIT C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1664
Mailing Address - Country:US
Mailing Address - Phone:773-549-6641
Mailing Address - Fax:
Practice Address - Street 1:1157 W NEWPORT AVE
Practice Address - Street 2:UNIT C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1664
Practice Address - Country:US
Practice Address - Phone:773-549-6641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.004143225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics