Kelly Anne Doodeman, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056-008511 Issued in IL

Practice address

2803 Butterfield Road
Suite 350
Oak Brook, IL 60523-1177

Phone

(630) 572-6301

Fax

(630) 572-6314

NPI assigned

Mar 30, 2011

Last updated

Mar 30, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1275822215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 BUTTERFIELD ROAD",
            "address_2": "SUITE 350",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231177",
            "telephone_number": "630-572-6301",
            "fax_number": "630-572-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 BUTTERFIELD ROAD",
            "address_2": "SUITE 350",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231177",
            "telephone_number": "630-572-6301",
            "fax_number": "630-572-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOODEMAN",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-008511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.