Active NPI
Andrea M Grant, OTR/L
- Occupational Therapist
- Gurnee, IL
National Provider Identifier
1255909321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.008653
- Practice address
- 1125 N Delany Rd
Gurnee, IL 60031-2007 - Phone
- (800) 974-4378
- Fax
- (630) 515-1536
- NPI assigned
- Jun 15, 2021
- Sex
- Female
- 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 | 056.008653 | IL | Primary |
Addresses
Primary practice location
1125 N Delany Rd
Gurnee, IL 60031-2007
Mailing address
24014 W Renwick Rd Ste F
Plainfield, IL 60544-8708
Phone (800) 974-4378
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623715200000",
"number": "1255909321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24014 W RENWICK RD STE F",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605448708",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 N DELANY RD",
"city": "GURNEE",
"state": "IL",
"postal_code": "600312007",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "ANDREA",
"middle_name": "M",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-15",
"last_updated": "2021-06-15",
"certification_date": "2021-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.008653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.