Provider Demographics
NPI:1902987803
Name:WESTON, BARBARA JUSTINA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JUSTINA
Last Name:WESTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8712 S WASHTENAW AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-1131
Mailing Address - Country:US
Mailing Address - Phone:708-422-4439
Mailing Address - Fax:312-569-8050
Practice Address - Street 1:820 S DAMEN AVE
Practice Address - Street 2:MP117
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3728
Practice Address - Country:US
Practice Address - Phone:312-569-6393
Practice Address - Fax:312-569-8050
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist