Provider Demographics
NPI:1366995037
Name:HUTCHINS, DANA PEOT (MS)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:PEOT
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:LYNNE
Other - Last Name:PEOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2352 W BLOOMINGDALE AVE
Mailing Address - Street 2:4E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4656
Mailing Address - Country:US
Mailing Address - Phone:414-430-2242
Mailing Address - Fax:
Practice Address - Street 1:1280 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1930
Practice Address - Country:US
Practice Address - Phone:312-624-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist