Provider Demographics
NPI:1841151677
Name:OFFORD, DAKOTA
Entity type:Individual
Prefix:
First Name:DAKOTA
Middle Name:
Last Name:OFFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 E GROVE ST APT 404
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2397
Mailing Address - Country:US
Mailing Address - Phone:815-501-9783
Mailing Address - Fax:
Practice Address - Street 1:1130 S CANAL ST STE 1375
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-5058
Practice Address - Country:US
Practice Address - Phone:815-501-9783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist