Individual provider Active NPI

Megan Sarah Chillson, OTR/L

  • Occupational Therapist
  • Mount Vernon, IL
National Provider Identifier
1508338872
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056012792 Issued in IL
Practice address
302 Broadway St
Mount Vernon, IL 62864
Phone
(618) 241-8595
Fax
(618) 241-8759
NPI assigned
Dec 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 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 056012792 IL Primary

Addresses

Primary practice location

302 Broadway St
Mount Vernon, IL 62864

Mailing address

4110 S Water Tower PL
Mount Vernon, IL 62864-6544
Phone (618) 242-1100

Other practice location 1

4110 S Water Tower Pl
Mount Vernon, IL 62864-6544
Phone (618) 242-1100

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

LicenseStateTypeSpecialty
056012792ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1508338872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 S WATER TOWER PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646544",
            "telephone_number": "618-242-1100",
            "fax_number": "618-244-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 BROADWAY ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-241-8595",
            "fax_number": "618-241-8759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4110 S Water Tower Pl",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628646544",
            "country_code": "US",
            "telephone_number": "618-242-1100",
            "fax_number": "618-244-5148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILLSON",
        "first_name": "MEGAN",
        "middle_name": "SARAH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.