Individual provider Active NPI

Teddy Hsu, OT

  • Occupational Therapist
  • Evanston, IL
National Provider Identifier
1235403577
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-009655 Issued in IL
Practice address
909 Davis St
Ste 220
Evanston, IL 60201-3683
Phone
(847) 733-7906
Fax
(847) 733-8405
NPI assigned
Mar 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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 056-009655 IL Primary

Addresses

Primary practice location

909 Davis St
Ste 220
Evanston, IL 60201-3683

Mailing address

909 Davis St
Ste 220
Evanston, IL 60201-3683
Phone (847) 733-7906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120807000054 IL Practitioner - Occupational Therapist in Private Practice 2769638824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-009655ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Apr 20, 2023 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Apr 20, 2023 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

1920 Maple Ave
Lisle, IL 60532
Phone (630) 725-7000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1235403577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 DAVIS ST",
            "address_2": "STE 220",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013683",
            "telephone_number": "847-733-7906",
            "fax_number": "847-733-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 DAVIS ST",
            "address_2": "STE 220",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013683",
            "telephone_number": "847-733-7906",
            "fax_number": "847-733-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSU",
        "first_name": "TEDDY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-009655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.