Active NPI
Pamela Taylor
- Developmental Therapist
- Chicago, IL
National Provider Identifier
1609401298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 7611 S Crandon Ave
Chicago, IL 60649-4116 - Phone
- (773) 510-4909
- NPI assigned
- Mar 4, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary | ||
| Early Intervention Provider Agency | 252Y00000X |
Addresses
Primary practice location
7611 S Crandon Ave
Chicago, IL 60649-4116
Mailing address
7611 S Crandon Ave
Chicago, IL 60649-4116
Phone (773) 510-4909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7611 | Other | NOT SURE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1609401298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7611 S CRANDON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606494116",
"telephone_number": "773-510-4909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7611 S CRANDON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606494116",
"telephone_number": "773-510-4909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "PAMELA",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-04",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOT SURE",
"identifier": "7611",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.