Individual provider Active NPI

Amy L Marshall, OT

  • Occupational Therapist
  • Libertyville, IL
National Provider Identifier
1477090215
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056011759 Issued in IL
Practice address
724 Florsheim Dr
Libertyville, IL 60048-3757
Phone
(847) 918-9077
Fax
(847) 918-9770
NPI assigned
Jan 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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 056011759 IL Primary

Addresses

Primary practice location

724 Florsheim Dr
Libertyville, IL 60048-3757

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202001973 IL Practitioner - Occupational Therapist in Private Practice 8123301819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

724 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 247-4000

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD CurrentSince Jan 31, 2017 Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince May 8, 2018 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Jan 31, 2017 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince May 8, 2018 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

1919 Skokie Valley Rd
Highland Park, IL 60035
Phone (224) 765-5500

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

1352 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 549-1460

724 Florsheim Dr
Libertyville, IL 60048
Phone (847) 247-4000

1600 16th St
Ste T14
Oak Brook, IL 60523
Phone (630) 572-9700

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

521 Green Bay Rd
Wilmette, IL 60091
Phone (847) 724-4864

521 Green Bay Rd
Fl 2
Wilmette, IL 60091
Phone (847) 724-4864

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1477090215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 FLORSHEIM DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483757",
            "telephone_number": "847-918-9077",
            "fax_number": "847-918-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.