Individual provider Active NPI

Erica Cundiff, DT

  • Developmental Therapist
  • Mokena, ID
National Provider Identifier
1831618545
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
10352 Aileen Ave.
Mokena, ID 60448
Phone
(708) 717-3540
NPI assigned
Sep 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

10352 Aileen Ave.
Mokena, ID 60448

Mailing address

10352 Aileen Ave
Mokena, IL 60448-3336

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": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1831618545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10352 AILEEN AVE",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604483336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10352 AILEEN AVE.",
            "city": "MOKENA",
            "state": "ID",
            "postal_code": "60448",
            "telephone_number": "708-717-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNDIFF",
        "first_name": "ERICA",
        "credential": "DT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; 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.