Provider Demographics
NPI:1679719488
Name:NERI, BETSY ANN (OT)
Entity type:Individual
Prefix:MS
First Name:BETSY
Middle Name:ANN
Last Name:NERI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 ROBEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3445
Mailing Address - Country:US
Mailing Address - Phone:630-969-9188
Mailing Address - Fax:
Practice Address - Street 1:1040 ROBEY AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3445
Practice Address - Country:US
Practice Address - Phone:630-969-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056000772225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist