Active NPI
Shannon Rose Leon, OTR
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1760103709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 1957 W Dickens Ave
Chicago, IL 60614-3934 - Phone
- (773) 789-9640
- NPI assigned
- Sep 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
1957 W Dickens Ave
Chicago, IL 60614-3934
Mailing address
4054 N Sheridan Rd Apt 1E
Chicago, IL 60613-2083
Phone (563) 449-4075
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1760103709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4054 N SHERIDAN RD APT 1E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132083",
"telephone_number": "563-449-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1957 W DICKENS AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606143934",
"telephone_number": "773-789-9640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON",
"first_name": "SHANNON",
"middle_name": "ROSE",
"name_prefix": "Miss",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-08",
"last_updated": "2022-09-08",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.