Individual provider Active NPI

Chun Wang, OT

  • Occupational Therapist
  • Crest Hill, IL
National Provider Identifier
1689425068
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056015929 Issued in IL
Practice address
16101 Weber Rd
Crest Hill, IL 60403-8812
Phone
(815) 306-1100
Fax
(815) 306-1105
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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 056015929 IL Primary

Addresses

Primary practice location

16101 Weber Rd
Crest Hill, IL 60403-8812

Mailing address

16101 Weber Rd
Crest Hill, IL 60403-8812
Phone (815) 306-1100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
056015929ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physicians, S.C. CurrentSince Apr 1, 2024 Accepting new patients

Locations

16101 Weber Rd
Crest Hill, IL 60403
Phone (815) 306-1100

14330 S Will Cook Rd
Homer Glen, IL 60491
Phone (708) 645-0288

Organizations & group practices 1

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": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1689425068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16101 WEBER RD",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604038812",
            "telephone_number": "815-306-1100",
            "fax_number": "815-306-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 WEBER RD",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604038812",
            "telephone_number": "815-306-1100",
            "fax_number": "815-306-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "CHUN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056015929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crest Hill, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.