Provider Demographics
NPI:1528335650
Name:WILLIAMS, JONI (COTA/L)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-3832
Mailing Address - Country:US
Mailing Address - Phone:708-253-9117
Mailing Address - Fax:
Practice Address - Street 1:2940 W 87TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-3832
Practice Address - Country:US
Practice Address - Phone:773-434-8787
Practice Address - Fax:773-434-8717
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.003329224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant