Individual provider Active NPI

Kathryn Holdren, OTR/L

  • Occupational Therapist
  • Elgin, IL
National Provider Identifier
1780171819
Registry record updated Apr 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.012347 Issued in IL
Practice address
790 Fletcher Dr
Elgin, IL 60123-4755
Phone
(847) 697-7800
NPI assigned
Apr 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2018

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 056.012347 IL Primary

Addresses

Primary practice location

790 Fletcher Dr
Elgin, IL 60123-4755

Mailing address

1208 Forest Dr
Elgin, IL 60123-1334
Phone (224) 217-1243

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
056.012347ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1523664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523664000000",
    "number": "1780171819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 FOREST DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601231334",
            "telephone_number": "224-217-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 FLETCHER DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234755",
            "telephone_number": "847-697-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDREN",
        "first_name": "KATHRYN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-14",
        "last_updated": "2018-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.012347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2018; 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.