Individual provider Active NPI

Candice Brattstrom Barrera, OT

  • Occupational Therapist
  • Homewood, IL
National Provider Identifier
1073769394
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056001712 Issued in IL
Practice address
18237 Kedzie Ave
Homewood, IL 60430-1411
Phone
(708) 957-1868
Fax
(708) 957-1925
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 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 056001712 IL Primary

Addresses

Primary practice location

18237 Kedzie Ave
Homewood, IL 60430-1411

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 2

IdentifierTypeStateIssuer
P00973809OtherILMEDICARE RAILROAD
P00852538OtherILMEDICARE RAILROAD

Other names 1

  • Candice Brattstrom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090212000178 IL Practitioner - Occupational Therapist in Private Practice 2466517149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3330 W 17TH St
Hazel Crest, IL 60429
Phone (708) 249-8347

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
90
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Occupational Therapist CurrentSince Jan 2, 2016 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC Occupational Therapist CurrentSince May 1, 2013 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Current Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince May 1, 2013 Accepting new patients
Athletic & Therapeutic Institute of Bourbonnais, LLC CurrentSince Jan 2, 2016 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Current Accepting new patients
Accelerated Rehabilitation Centers LTD Occupational Therapist Past Accepting new patients
Accelerated Rehabilitation Centers, LTD Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

4131 167th St
Country Club Hills, IL 60478
Phone (708) 365-5507

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

3330 W 177th St
Ste 2B
Hazel Crest, IL 60429
Phone (708) 249-8346

18237 Kedzie Ave
Homewood, IL 60430
Phone (630) 598-2650

4555 Lincoln Hwy
Matteson, IL 60443
Phone (708) 283-0021

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

16651 Harlem Ave
Tinley Park, IL 60477
Phone (708) 444-2467

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1073769394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18237 KEDZIE AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301411",
            "telephone_number": "708-957-1868",
            "fax_number": "708-957-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTSTROM BARRERA",
        "first_name": "CANDICE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056001712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00973809",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00852538",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "BRATTSTROM",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.