Individual provider Active NPI

Melissa Ann Duncan, OTR/L

  • Occupational Therapist
  • Glenview, IL
National Provider Identifier
1336650035
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056012166 Issued in IL
Practice address
41 Waukegan Rd
Glenview, IL 60025-5154
Phone
(847) 707-6744
NPI assigned
Oct 20, 2017
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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 056012166 IL Primary

Addresses

Primary practice location

41 Waukegan Rd
Glenview, IL 60025-5154

Mailing address

Central Parkway
Store# 210
Highland Park, IL 60035
Phone (914) 265-4522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624000480 IL Practitioner - Occupational Therapist in Private Practice 3476954785 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Jun 16, 2021 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Occupational Therapist CurrentSince Jun 16, 2021 Accepting new patients
Little Steps Pediatric Physical Therapy, PC Past Accepting new patients

Locations

204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225

799 Central Ave
Ste 210
Highland Park, IL 60035
Phone (847) 681-8720

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 3

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": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1336650035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTRAL PARKWAY",
            "address_2": "STORE# 210",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "60035",
            "telephone_number": "914-265-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600255154",
            "telephone_number": "847-707-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.