Individual provider Active NPI

Carleen Colvin

  • Occupational Therapist
  • Glasford, IL
National Provider Identifier
1578045696
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.007865 Issued in IL
Practice address
29788 E Phillips Rd
Glasford, IL 61533-9441
Phone
(309) 303-7233
NPI assigned
Sep 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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 056.007865 IL Primary

Addresses

Primary practice location

29788 E Phillips Rd
Glasford, IL 61533-9441

Mailing address

29788 E Phillips Rd
Glasford, IL 61533-9441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618000543 IL Practitioner - Occupational Therapist in Private Practice 4284145038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

1320 Executive CT
Pekin, IL 61554-6096
Phone (309) 249-8789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.007865ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast, LLC Occupational Therapist CurrentSince May 18, 2025 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince May 11, 2025 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince May 11, 2025 Accepting new patients

Locations

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

117 N Western Ave
Peoria, IL 61604
Phone (309) 674-2400

Organizations & group practices 3

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": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1578045696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29788 E PHILLIPS RD",
            "city": "GLASFORD",
            "state": "IL",
            "postal_code": "615339441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29788 E PHILLIPS RD",
            "city": "GLASFORD",
            "state": "IL",
            "postal_code": "615339441",
            "telephone_number": "309-303-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "CARLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.007865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.