Individual provider Active NPI

Edna Melissa McCarthy, MSOTR/L

  • Occupational Therapist
  • Glenview, IL
National Provider Identifier
1598094930
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056003170 Issued in IL
Practice address
3703 W Lake Ave
Suite 200
Glenview, IL 60026-1223
Phone
(847) 998-1188
NPI assigned
Dec 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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 056003170 IL Primary

Addresses

Primary practice location

3703 W Lake Ave
Suite 200
Glenview, IL 60026-1223

Mailing address

381 Maxwell St
PO Box 1294
Beecher, IL 60401
Phone (815) 347-0803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919001108 MI Practitioner - Occupational Therapist in Private Practice 5698150290 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056003170ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince May 28, 2022 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince May 28, 2022 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

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": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1598094930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 MAXWELL ST",
            "address_2": "PO BOX 1294",
            "city": "BEECHER",
            "state": "IL",
            "postal_code": "60401",
            "telephone_number": "815-347-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 W LAKE AVE",
            "address_2": "SUITE 200",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261223",
            "telephone_number": "847-998-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "EDNA",
        "middle_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "MSOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056003170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.