Provider Demographics
NPI:1447066113
Name:ZELL, ALEXANDRIA (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:ZELL
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:
Other - Last Name:NOVICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:1200 MEGHAN AVE
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-4012
Mailing Address - Country:US
Mailing Address - Phone:630-329-1420
Mailing Address - Fax:
Practice Address - Street 1:4701 N OAK ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012-3309
Practice Address - Country:US
Practice Address - Phone:815-788-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056014475225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist