Provider Demographics
NPI:1902241706
Name:WILLE, SHERRY L (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:WILLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:L
Other - Last Name:WITEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:10672 MILLERS WAY
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8738
Mailing Address - Country:US
Mailing Address - Phone:708-341-5503
Mailing Address - Fax:708-237-7296
Practice Address - Street 1:10330 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1971
Practice Address - Country:US
Practice Address - Phone:708-237-7200
Practice Address - Fax:708-237-7296
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-003918225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist