Individual provider Active NPI

Brad Edward Egan, OTD, OTRL

  • Pediatric Occupational Therapist
  • Chicago, IL
National Provider Identifier
1639384639
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056006892 Issued in IL
Practice address
5646 N Kenmore Ave
4D
Chicago, IL 60660-4621
Phone
(864) 266-3130
NPI assigned
May 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056006892 IL
Pediatric Occupational Therapist 225XP0200X 056006892 IL Primary

Addresses

Primary practice location

5646 N Kenmore Ave
4D
Chicago, IL 60660-4621

Mailing address

5646 N Kenmore Ave
Unit 4D
Chicago, IL 60660-4621
Phone (864) 266-3130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250115001595 IL Practitioner - Occupational Therapist in Private Practice 7719415942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

2625 Techny Rd
Northbrook, IL 60062-5995
Phone (888) 531-2204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056006892ILMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Occupational Therapist CurrentSince Aug 1, 2025 Accepting new patients
Brothers Therapy Services, LLC Occupational Therapist Current Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Dec 14, 2024 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Dec 14, 2024 Accepting new patients

Locations

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

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Organizations & group practices 4

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": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639384639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5646 N KENMORE AVE",
            "address_2": "UNIT 4D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604621",
            "telephone_number": "864-266-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5646 N KENMORE AVE",
            "address_2": "4D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604621",
            "telephone_number": "864-266-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "BRAD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "OTD, OTRL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056006892",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056006892",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 11, 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.