Individual provider Active NPI

Corinne Sidney, OTR/L

  • Occupational Therapist
  • Savoy, IL
National Provider Identifier
1467849562
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.010086 Issued in IL
Practice address
302 Burwash Ave
Savoy, IL 61874-9572
Phone
(217) 402-9646
NPI assigned
Apr 16, 2015
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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 056.010086 IL Primary

Addresses

Primary practice location

302 Burwash Ave
Savoy, IL 61874-9572

Mailing address

PO Box 504469
Saint Louis, MO 63150-4469
Phone (217) 402-9646

Other names 1

  • Corinne Baker Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231222000547 IL Practitioner - Occupational Therapist in Private Practice 3678923281 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.010086ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Nov 12, 2023 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Nov 12, 2023 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

2800 Desplaines Ave
Riverside, IL 60546
Phone (708) 443-4217

Organizations & group practices 2

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": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1467849562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504469",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631504469",
            "telephone_number": "217-402-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 BURWASH AVE",
            "city": "SAVOY",
            "state": "IL",
            "postal_code": "618749572",
            "telephone_number": "217-402-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDNEY",
        "first_name": "CORINNE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-16",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.010086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINNE",
            "last_name": "BAKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savoy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.