Individual provider Active NPI

Erica Michelle Wilham

  • Occupational Therapy Assistant
  • Skokie, IL
National Provider Identifier
1700245701
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057004447 Issued in IL
Practice address
9700 Gross Point Rd
Skokie, IL 60076-1175
Phone
(847) 929-3326
NPI assigned
Feb 18, 2016
Last updated
Feb 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057004447 IL Primary

Addresses

Primary practice location

9700 Gross Point Rd
Skokie, IL 60076-1175

Mailing address

3410 Moore Rd
Springfield, IL 62707-2517
Phone (217) 971-2971

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
057004447ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1700245701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 MOORE RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627072517",
            "telephone_number": "217-971-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 GROSS POINT RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761175",
            "telephone_number": "847-929-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHAM",
        "first_name": "ERICA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057004447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.