Brenda Kay Bollivar, DT

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

BB94480598P Issued in IL

Practice address

2300 West Lefevre Road
Sterling, IL 61081-7703

Phone

(815) 626-3115

Fax

(815) 626-9640

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Rock River Valley Self Help Enterprises, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Sterling, IL
  • NPI 1588029946
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114049061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18410 HURD ROAD",
            "city": "PROPHETSTOWN",
            "state": "IL",
            "postal_code": "612779379",
            "telephone_number": "815-537-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 WEST LEFEVRE ROAD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610817703",
            "telephone_number": "815-626-3115",
            "fax_number": "815-626-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLIVAR",
        "first_name": "BRENDA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "DT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "BB94480598P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle Beyer
• Bi County Special Ed
• Kayla M Bland, PA-C
• Angel Blazquez, M.D.
• Stephanie Ann Boers, BSW
• Cynthia Sue Book, DT
• Brittany May Borto, DO
• Debra Hope Bowman, M.D.
• Kelly Ann Bramm
• Megan M Brandt

• Developmental Therapist in Sterling, IL
• Providers in Sterling, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.