Alicia Dawn Penny

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

18499 Zurich LN
Tinley Park, IL 60477-4405

Phone

(312) 485-3000

Fax

(708) 429-7780

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 4, 2011.

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1386928745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18499 ZURICH LN",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774405",
            "telephone_number": "312-485-3000",
            "fax_number": "708-429-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18499 ZURICH LN",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774405",
            "telephone_number": "312-485-3000",
            "fax_number": "708-429-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNY",
        "first_name": "ALICIA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.