Individual provider Active NPI

Evan Lines, OTR

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1265931562
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056013025 Issued in IL
Practice address
1611 W Harrison St Ste 107
Chicago, IL 60612-4861
Phone
(877) 632-6637
NPI assigned
Feb 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31006516A IN
Occupational Therapist 225X00000X 056013025 IL Primary

Addresses

Primary practice location

1611 W Harrison St Ste 107
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St Ste 107
Chicago, IL 60612-4861
Phone (877) 632-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180209001553 IN Practitioner - Occupational Therapist in Private Practice 8123388204 Reassigns benefits to 2 organizations
I20190510000950 IL Practitioner - Occupational Therapist in Private Practice 8123388204 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056013025ILMDOccupational Therapist
31006516AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Ambulatory Surgery Centers, LLC Current Accepting new patients
Beltway Surgery Centers LLC Current Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince May 6, 2019 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince May 6, 2019 Accepting new patients
Orthomidwest, PLLC Occupational Therapist CurrentSince Jul 1, 2022 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 107
Chicago, IL 60612
Phone (312) 432-2513

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Ste 300
Chicago, IL 60612
Phone (312) 432-2300

2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

2450 Wolf Rd
Ste F
Westchester, IL 60154
Phone (708) 236-2750

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

8501 Harcourt Rd
Indianapolis, IN 46260
Phone (317) 471-4339

9200 Calumet Ave
#300
Munster, IN 46321

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

9200 Calumet Ave
Ste N500
Munster, IN 46321
Phone (219) 513-9955

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1265931562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINES",
        "first_name": "EVAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31006516A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056013025",
            "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 Sep 12, 2023; 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.