Provider Demographics
NPI:1619573763
Name:BELL, ASHLI MICHELLE
Entity type:Individual
Prefix:
First Name:ASHLI
Middle Name:MICHELLE
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11394 WEST ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:62685-6513
Mailing Address - Country:US
Mailing Address - Phone:217-416-3353
Mailing Address - Fax:
Practice Address - Street 1:11394 WEST ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:IL
Practice Address - Zip Code:62685-6513
Practice Address - Country:US
Practice Address - Phone:217-416-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057004039224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant