Active NPI
Emily Coleman
- Occupational Therapist
- Crestwood, IL
National Provider Identifier
1063842672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.009815
- Practice address
- 14255 Cicero Ave
Crestwood, IL 60445-2154 - Phone
- (708) 371-0400
- NPI assigned
- Nov 18, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.009815 | IL | Primary |
Addresses
Primary practice location
14255 Cicero Ave
Crestwood, IL 60445-2154
Mailing address
539 Muskegon Ave
Calumet City, IL 60409-3337
Phone (773) 543-1695
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.009815 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384732800000",
"number": "1063842672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "539 MUSKEGON AVE",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604093337",
"telephone_number": "773-543-1695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14255 CICERO AVE",
"city": "CRESTWOOD",
"state": "IL",
"postal_code": "604452154",
"telephone_number": "708-371-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-18",
"last_updated": "2013-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.009815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.