Active NPI
Mary Susan Miller, COTA/L
- Gerontology Occupational Therapist
- Orland Park, IL
National Provider Identifier
1548412752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- 057-001086
- Practice address
- 7756 Wheeler Dr
Orland Park, IL 60462-5029 - Phone
- (708) 614-9439
- NPI assigned
- Oct 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | 057-001086 | IL | Primary |
Addresses
Primary practice location
7756 Wheeler Dr
Orland Park, IL 60462-5029
Mailing address
7756 Wheeler Dr
Orland Park, IL 60462-5029
Phone (708) 614-9439
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 |
|---|---|---|---|
| 057-001086 | IL | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1548412752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7756 WHEELER DR",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604625029",
"telephone_number": "708-614-9439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7756 WHEELER DR",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604625029",
"telephone_number": "708-614-9439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MARY",
"middle_name": "SUSAN",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "IL",
"license": "057-001086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.