Active NPI
Alan Minyard, M.S., OTR/L
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1194209924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056012590
- Practice address
- 1409 W Carroll Ave
Chicago, IL 60607-1105 - Phone
- (312) 733-0883
- NPI assigned
- Sep 18, 2018
- Last updated
- Mar 14, 2019
- Sex
- Male
- 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 | 056012590 | IL | Primary |
Addresses
Primary practice location
1409 W Carroll Ave
Chicago, IL 60607-1105
Mailing address
1815 S Wolf Rd
Hillside, IL 60162-2110
Phone (708) 236-0979
Other practice location 1
3235 W Montrose Ave
Chicago, IL 60618-1223
Phone (773) 878-7868
Other practice location 2
1815 S Wolf Rd
Hillside, IL 60162-2110
Phone (708) 236-0979
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056012590 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyas Landing, Inc. | Past | Accepting new patients | |
| Aspire of Illinois | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Early Intervention Provider Agency
- Chicago, IL
- NPI 1053621391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552521600000",
"number": "1194209924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 S WOLF RD",
"city": "HILLSIDE",
"state": "IL",
"postal_code": "601622110",
"telephone_number": "708-236-0979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 W CARROLL AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606071105",
"telephone_number": "312-733-0883"
}
],
"practiceLocations": [
{
"address_1": "3235 W Montrose Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606181223",
"country_code": "US",
"telephone_number": "773-878-7868",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1815 S Wolf Rd",
"address_purpose": "LOCATION",
"city": "Hillside",
"state": "IL",
"postal_code": "601622110",
"country_code": "US",
"telephone_number": "708-236-0979",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MINYARD",
"first_name": "ALAN",
"credential": "M.S., OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-18",
"last_updated": "2019-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056012590",
"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 Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.