Active NPI
Elizabeth Marie Carlson, OTR/L
- Occupational Therapist
- La Grange, IL
National Provider Identifier
1396945002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 4735 Willow Springs Rd
La Grange, IL 60525-6130 - Phone
- (708) 352-6900
- NPI assigned
- Jul 20, 2007
- 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 | IL | Primary |
Addresses
Primary practice location
4735 Willow Springs Rd
La Grange, IL 60525-6130
Mailing address
4202 Forest Ave
Western Springs, IL 60558-1342
Phone (708) 246-1137
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.007946 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1396945002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4202 FOREST AVE",
"city": "WESTERN SPRINGS",
"state": "IL",
"postal_code": "605581342",
"telephone_number": "708-246-1137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4735 WILLOW SPRINGS RD",
"city": "LA GRANGE",
"state": "IL",
"postal_code": "605256130",
"telephone_number": "708-352-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "ELIZABETH",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-20",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Grange, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.