Individual provider Active NPI

Callan Patricia McDermott, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • Willowbrook, IL
National Provider Identifier
1194356725
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
6300 Kingery Hwy Ste 102
Willowbrook, IL 60527-2250
Phone
(815) 469-1500
NPI assigned
Feb 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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 Primary

Addresses

Primary practice location

6300 Kingery Hwy Ste 102
Willowbrook, IL 60527-2250

Mailing address

6300 Kingery Hwy Ste 102
Willowbrook, IL 60527-2250
Phone (815) 469-1500

Other practice location 1

5420 Old Orchard Rd Ste 1B
Skokie, IL 60077-1053
Phone (847) 604-0955

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Childrens Therapy Occupational Therapist PastSince Apr 24, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1580601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1194356725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 KINGERY HWY STE 102",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272250",
            "telephone_number": "815-469-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 KINGERY HWY STE 102",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272250",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5420 Old Orchard Rd Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600771053",
            "country_code": "US",
            "telephone_number": "847-604-0955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "CALLAN",
        "middle_name": "PATRICIA",
        "name_prefix": "Miss",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-02",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.