Provider Demographics
NPI:1447417415
Name:SPRADLIN, BONI LYNN (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:BONI
Middle Name:LYNN
Last Name:SPRADLIN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:DR
Other - First Name:BONI
Other - Middle Name:LYNN
Other - Last Name:TRUAX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:844 KENSINGTON PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-4944
Mailing Address - Country:US
Mailing Address - Phone:630-643-1318
Mailing Address - Fax:
Practice Address - Street 1:844 KENSINGTON PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4944
Practice Address - Country:US
Practice Address - Phone:630-643-1318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.006812225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist