Provider Demographics
NPI:1033645643
Name:DALEY, DIANA (COTA)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 PASQUINELLI DR STE 204
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1291
Mailing Address - Country:US
Mailing Address - Phone:630-560-0136
Mailing Address - Fax:
Practice Address - Street 1:5731 129TH ST APT 2W
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60418-1143
Practice Address - Country:US
Practice Address - Phone:708-476-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CONAOtherWILL PROVIDE ONCE RECEIVED.