Individual provider Active NPI

Patrick Landsdale Oconnor, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1093908303
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1647 N Humboldt Blvd
Chicago, IL 60647-5015
Phone
(773) 216-6144
Fax
(773) 486-5814
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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 IL Primary

Addresses

Primary practice location

1647 N Humboldt Blvd
Chicago, IL 60647-5015

Mailing address

1647 N Humboldt Blvd
Chicago, IL 60647-5015
Phone (773) 216-6144

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
056004643ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1093908303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 N HUMBOLDT BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475015",
            "telephone_number": "773-216-6144",
            "fax_number": "773-486-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 N HUMBOLDT BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475015",
            "telephone_number": "773-216-6144",
            "fax_number": "773-486-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "PATRICK",
        "middle_name": "LANDSDALE",
        "name_prefix": "Mr.",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "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 Aug 20, 2007; 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.