Vivian Odafe, OTR

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

056.002908 Issued in IL

Practice address

8700 31St St
Brookfield, IL 60513-1000

Phone

(708) 485-5809

NPI assigned

May 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1700265758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 31ST ST",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "605131000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 31ST ST",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "605131000",
            "telephone_number": "708-485-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODAFE",
        "first_name": "VIVIAN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "IL",
            "license": "056.002908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Occupational Therapist in Brookfield, IL
• Providers in Brookfield, IL by specialty
• Gerontology Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.