Active NPI
Gloria Dean Anderson, O.T.
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1073947503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.003668
- Practice address
- 222 S. Riverside Palaza Suite 830
Supplemental Health Care
Chicago, IL 60606 - Phone
- (312) 416-3804
- NPI assigned
- Sep 3, 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 | 056.003668 | IL | Primary |
Addresses
Primary practice location
222 S. Riverside Palaza Suite 830
Supplemental Health Care
Chicago, IL 60606
Mailing address
5836 S. Prairie Ave.
Unit 2
Chicago, IL 60637-4082
Phone (773) 426-5911
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.003668 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378252800000",
"number": "1073947503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5836 S. PRAIRIE AVE.",
"address_2": "UNIT 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606374082",
"telephone_number": "773-426-5911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 S. RIVERSIDE PALAZA SUITE 830",
"address_2": "SUPPLEMENTAL HEALTH CARE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60606",
"telephone_number": "312-416-3804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "GLORIA",
"middle_name": "DEAN",
"name_prefix": "Ms.",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-03",
"last_updated": "2013-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.003668",
"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 Sep 4, 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.