Individual provider Active NPI

Erin T. Elliott, O.T.R.

  • Occupational Therapist
  • Crystal Lake, IL
National Provider Identifier
1700011012
Registry record updated May 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.008697 Issued in IL
Practice address
471 W Terra Cotta Ave
Crystal Lake, IL 60014-3434
Phone
(815) 455-0550
NPI assigned
May 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2009

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 056.008697 IL Primary

Addresses

Primary practice location

471 W Terra Cotta Ave
Crystal Lake, IL 60014-3434

Mailing address

3407 Lakewood Dr
Crystal Lake, IL 60012-2076

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

State licenses

LicenseStateTypeSpecialty
056.008697ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1242432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242432000000",
    "number": "1700011012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 LAKEWOOD DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600122076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 W TERRA COTTA AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143434",
            "telephone_number": "815-455-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ERIN",
        "middle_name": "T.",
        "credential": "O.T.R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-16",
        "last_updated": "2009-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.008697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2009; 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.