Prendergast Pediatrics P.C.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056-008197 Issued in IL

Legal business name

PRENDERGAST PEDIATRICS P.C.

Practice address

547 W Surf St
Unit 4
Chicago, IL 60657-6034

Phone

(810) 656-2863

NPI assigned

Oct 9, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Michaja Lynn Prendergast, M.S. OTR/L

Title

Owner

Phone

(810) 656-2863

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1740532126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 W SURF ST",
            "address_2": "UNIT 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576034",
            "telephone_number": "810-656-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 W SURF ST",
            "address_2": "UNIT 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576034",
            "telephone_number": "810-656-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRENDERGAST PEDIATRICS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "PRENDERGAST",
        "authorized_official_first_name": "MICHAJA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-656-2863",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S. OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-008197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Illinois Medical PC
• Premise Health of Illinois Medical PC
• Premise Health of Illinois Medical, PC
• Premium Eyecare, LTD.
• Tatiana Prendella, LSW
• Erica Prendergast
• Francis M. Prendergast, MD
• Heather M Prendergast
• Kelly Prendergast, LPC
• Michaja Lynn Prendergast

• Occupational Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.