Individual provider Active NPI

Elsy Michael

  • Occupational Therapist
  • Norridge, IL
National Provider Identifier
1629496997
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.010134 Issued in IL
Practice address
7001 W Cullom Ave
Norridge, IL 60706-7100
Phone
(708) 457-0700
NPI assigned
Apr 2, 2014
Last updated
Apr 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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 056.010134 IL Primary

Addresses

Primary practice location

7001 W Cullom Ave
Norridge, IL 60706-7100

Mailing address

16170 Kingsport Rd
Orland Park, IL 60467-5602
Phone (708) 326-1550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260428001900 VA Practitioner - Occupational Therapist in Private Practice 4183011497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Saginaw Valley Medical College - NLG, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

503 N Main St
Chase City, VA 23924-1407

700 W 5TH St
Clare, MI 48617-9414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.010134ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Therapy & Consultation, Inc. Occupational Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1629496997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16170 KINGSPORT RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675602",
            "telephone_number": "708-326-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 W CULLOM AVE",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "607067100",
            "telephone_number": "708-457-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "ELSY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.010134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; 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.