Individual provider Active NPI

Elizabeth Watson, VOCATIONAL THERAPIST

  • Recreation Therapist
  • Downers Grove, IL
National Provider Identifier
1053581090
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
Practice address
1040 Robey Ave
Downers Grove, IL 60516-3445
Phone
(630) 969-9188
NPI assigned
Mar 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X IL Primary

Addresses

Primary practice location

1040 Robey Ave
Downers Grove, IL 60516-3445

Mailing address

9901 Linn Station Rd
Louisville, KY 40223-3808
Phone (800) 866-0860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180-001236ILMDRecreation Therapist

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1053581090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 LINN STATION RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233808",
            "telephone_number": "800-866-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 ROBEY AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163445",
            "telephone_number": "630-969-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ELIZABETH",
        "credential": "VOCATIONAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.