Individual provider Active NPI

Julie Marie Conrad, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1053737957
Registry record updated Mar 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056010486 Issued in IL
Practice address
1436 W Randolph St
204
Chicago, IL 60607-1405
Phone
(312) 733-0883
Fax
(888) 733-1772
NPI assigned
Mar 15, 2014
Last updated
Mar 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056010486 IL Primary

Addresses

Primary practice location

1436 W Randolph St
204
Chicago, IL 60607-1405

Mailing address

7230 W Myrtle Ave
Chicago, IL 60631-1942
Phone (773) 304-7789

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
056010486ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1394841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394841600000",
    "number": "1053737957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7230 W MYRTLE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311942",
            "telephone_number": "773-304-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 W RANDOLPH ST",
            "address_2": "204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071405",
            "telephone_number": "312-733-0883",
            "fax_number": "888-733-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-15",
        "last_updated": "2014-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056010486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2014; 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.