Individual provider Active NPI

Lillian Marie Tarnow, OTR

  • Occupational Therapist
  • Skokie, IL
National Provider Identifier
1720152630
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-003759 Issued in IL
Practice address
4711 Golf Rd Ste 403
Skokie, IL 60076-1242
Phone
(847) 674-2630
Fax
(847) 674-4042
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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 056-003759 IL Primary

Addresses

Primary practice location

4711 Golf Rd Ste 403
Skokie, IL 60076-1242

Mailing address

3630 N Saint Louis Ave
Chicago, IL 60618-4226
Phone (773) 267-4142

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
056-003759ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1720152630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 N SAINT LOUIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184226",
            "telephone_number": "773-267-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 403",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761242",
            "telephone_number": "847-674-2630",
            "fax_number": "847-674-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARNOW",
        "first_name": "LILLIAN",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-003759",
            "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 Dec 7, 2011; 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.