Provider Demographics
NPI:1871200865
Name:BIBA, PAIGE MILLET (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:MILLET
Last Name:BIBA
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:MILLET
Other - Last Name:DEBOER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:4511 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1324
Mailing Address - Country:US
Mailing Address - Phone:630-329-7244
Mailing Address - Fax:
Practice Address - Street 1:2901 JACKSON DR
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1032
Practice Address - Country:US
Practice Address - Phone:630-795-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.013728225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist