Active NPI
Emma Pearl Brennan, OTR
- Occupational Therapist
- Evergreen Park, IL
National Provider Identifier
1518659424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056015199
- Practice address
- 2800 W 95TH St
Evergreen Park, IL 60805-2701 - Phone
- (708) 422-6200
- NPI assigned
- May 22, 2023
- 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 | 056015199 | IL | Primary |
Addresses
Primary practice location
2800 W 95TH St
Evergreen Park, IL 60805-2701
Mailing address
2800 W 95TH St
Evergreen Park, IL 60805-2701
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 |
|---|---|---|---|
| 056015199 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1518659424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 W 95TH ST",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 W 95TH ST",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052701",
"telephone_number": "708-422-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "EMMA",
"middle_name": "PEARL",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056015199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.