Active NPI
Colleen Ann O'Brien, OTR
- Occupational Therapist
- Addison, IL
National Provider Identifier
1134401409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.003410
- Practice address
- 222 North Kennedy Dr.
Addison, IL 60101 - Phone
- (630) 458-2462
- NPI assigned
- Sep 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 056.003410 | IL | Primary |
Addresses
Primary practice location
222 North Kennedy Dr.
Addison, IL 60101
Mailing address
333 1St St N Ste 200
Jacksonville Beach, FL 32250-6939
Phone (904) 241-9231
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 |
|---|---|---|---|
| 056.003410 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1134401409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 1ST ST N STE 200",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322506939",
"telephone_number": "904-241-9231",
"fax_number": "888-794-5038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 NORTH KENNEDY DR.",
"city": "ADDISON",
"state": "IL",
"postal_code": "60101",
"telephone_number": "630-458-2462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "COLLEEN",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.003410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Addison, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.