Provider Demographics
NPI:1073945291
Name:WAYNAUSKAS, AMANDA L (MOTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:L
Last Name:WAYNAUSKAS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GAME FARM RD
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1133
Mailing Address - Country:US
Mailing Address - Phone:630-553-5513
Mailing Address - Fax:
Practice Address - Street 1:800 GAME FARM RD
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1133
Practice Address - Country:US
Practice Address - Phone:630-553-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009529225X00000X
IA002145225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist