Provider Demographics
NPI:1699087031
Name:SUGGITT, JENNIFER LYNN (OTR/L, CLT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:SUGGITT
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:CHIRCHIRILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CLT
Mailing Address - Street 1:8434 CORCORAN RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-1666
Mailing Address - Country:US
Mailing Address - Phone:708-467-0657
Mailing Address - Fax:
Practice Address - Street 1:8434 CORCORAN RD
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60480-1666
Practice Address - Country:US
Practice Address - Phone:708-467-0657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0200X
IL056.009557225XP0200X
NY016038-1225XP0200X
IL056009557225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics