Provider Demographics
NPI:1457237125
Name:MEDLICOTT, MARIA LUNA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LUNA
Last Name:MEDLICOTT
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 1:544 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1213
Mailing Address - Country:US
Mailing Address - Phone:630-470-3737
Mailing Address - Fax:
Practice Address - Street 1:2901 FINLEY RD STE 102
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1774
Practice Address - Country:US
Practice Address - Phone:630-495-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics