Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Minetta Wallingford, OTR/L

Individual provider Occupational Therapist · NPI 1174160634

Minetta Wallingford, OTR/L is an Occupational Therapist in Riverside, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2019
What do these letters mean?
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

423 Addison Rd
Riverside, IL 60546-2007
Phone: (773) 715-8463
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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 056.003498 (IL)

Record details

NPI number1174160634
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedDecember 4, 2019
Last updated in NPPESDecember 4, 2019

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