Provider Demographics
NPI:1447938386
Name:VERCELLOTTI, HANNAH (MSOT, OTR/L)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:VERCELLOTTI
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20853 ROCK RUN DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-9323
Mailing Address - Country:US
Mailing Address - Phone:815-545-9664
Mailing Address - Fax:
Practice Address - Street 1:823 N 129TH INFANTRY DR STE 101
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8347
Practice Address - Country:US
Practice Address - Phone:815-729-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056015100225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand