Ellen Marie Tanner, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.007674 Issued in IL

Practice address

4823 Storeyland Dr
Alton, IL 62002-5835

Phone

(312) 593-4871

NPI assigned

Apr 16, 2007

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

Other names 1

• Ms. Ellen Marie Tanner Former name

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1417172172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4823 STOREYLAND DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025835",
            "telephone_number": "312-593-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4823 STOREYLAND DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025835",
            "telephone_number": "312-593-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.007674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "TANNER",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacquelyn Elaine Sweetman, PT
• Wonil Tae, MD
• Laquita Tague
• Dawn Nicole Talbert, D.O.
• Joseph M Talsky, MD
• Jennifer Tapen
• Lee A Tardino, MSN ANP
• Lori Michele Tassinari, OTR
• Steve Tavernier, BSW
• Christine M Taylor, M.D.

• Occupational Therapist in Alton, IL
• Providers in Alton, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.