Individual
JAMES D DELOACH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
76359 AL HIGHWAY 77, SUITE B, LINCOLN, AL 35096-5039
(630) 296-2222
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0815
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51507914
BS
AL
01
—
51509009
BS
AL
01
—
51509034
BCBS
AL
01
—
51509035
BCBS
AL
01
—
51524965
BCBS
AL
01
—
51526420
BCBS
AL
Enumeration date
06/15/2006
Last updated
03/02/2017
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