Individual provider Active NPI

Tara Williams

  • Developmental Therapist
  • Tinley Park, IL
National Provider Identifier
1629317003
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
6600 180TH St
Tinley Park, IL 60477-4143
Phone
(708) 253-5622
NPI assigned
Feb 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

6600 180TH St
Tinley Park, IL 60477-4143

Mailing address

6600 180TH St
Tinley Park, IL 60477-4143
Phone (708) 253-5622

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1629317003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 180TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774143",
            "telephone_number": "708-253-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 180TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774143",
            "telephone_number": "708-253-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.