Provider Demographics
NPI:1881315588
Name:BYRNES, MEREDITH THERESA (OTR/L)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:THERESA
Last Name:BYRNES
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 1:9530 S KILBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3208
Mailing Address - Country:US
Mailing Address - Phone:708-691-8826
Mailing Address - Fax:
Practice Address - Street 1:1347 CRYSTAL AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-0149
Practice Address - Country:US
Practice Address - Phone:630-778-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.013878225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist