Provider Demographics
NPI:1962055855
Name:ORWAT, BEVERLY ELEANOR (OTR/L)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ELEANOR
Last Name:ORWAT
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 1:342 79TH PL
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2433
Mailing Address - Country:US
Mailing Address - Phone:630-818-6897
Mailing Address - Fax:
Practice Address - Street 1:342 79TH PL
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-2433
Practice Address - Country:US
Practice Address - Phone:630-818-6897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056003822225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics