Brad A Wildi, MOT OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.006087 Issued in IL

Practice address

599 Grosvener LN
Elk Grove Village, IL 60007-4277

Phone

(847) 409-4869

NPI assigned

May 24, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1013277938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 GROSVENER LN",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600074277",
            "telephone_number": "847-409-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 GROSVENER LN",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600074277",
            "telephone_number": "847-409-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDI",
        "first_name": "BRAD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MOT OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.006087",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "9333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grady M. Wick, M.D.
• Heather M Wicker, CST/CSFA
• Ashley Marie Wierema, B.A
• Gary Wilczek
• Natasa Wilczewski
• Alyssa Wilhelm, MA, QMHP
• Lukrecja Wilk, LPC, CADC
• William I Kim MD SC
• Tasha Lenette Williams, PHARMD
• Diane Willow, LCPC

• Occupational Therapist in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.