Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Basia C. Z. Wallace, OTD, OTR/L

Individual provider Occupational Therapist · NPI 1770351991

Dr. Basia C. Z. Wallace, OTD, OTR/L is an Occupational Therapist in Crystal Lake, Illinois. Licensed in Illinois. Registered with an NPI since 2023.

Licensed in
IL
In the registry since
2023
What do these letters mean?
OTD — Doctor of Occupational Therapy
The doctoral degree in occupational therapy.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

394 Federal Dr
Crystal Lake, IL 60014
Phone: (815) 459-3810
Fax: (815) 356-3550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 056.015836 (IL)

Record details

NPI number1770351991
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTD , OTR/L
Sole proprietorNo
NPI enumeratedDecember 18, 2023
Last updated in NPPESDecember 18, 2023
Certification dateDecember 18, 2023

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