Individual provider Active NPI

Madeleine Michelle Anderson, OTR

  • Pediatric Occupational Therapist
  • Chicago, IL
National Provider Identifier
1831849660
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
4619 N Ravenswood Ave Ste 204
Chicago, IL 60640-4579
Phone
(773) 697-7333
NPI assigned
Mar 25, 2022
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X NU Primary

Addresses

Primary practice location

4619 N Ravenswood Ave Ste 204
Chicago, IL 60640-4579

Mailing address

4619 N Ravenswood Ave Ste 204
Chicago, IL 60640-4579
Phone (773) 697-7333

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

Practice roles

OrganizationSpecialtyStatusNew patients
4619 N. Ravenswood Ave. Suite 204 Chicago, Il 60640 CurrentSince Jun 25, 2023 Accepting new patients
Sensable Kids, P.C. Pediatrics CurrentSince Mar 27, 2022 Accepting new patients

Locations

4619 N Ravenswood Ave
Ste 204
Chicago, IL 60640
Phone (773) 697-7333

4619 N Ravenswood Ave
Ste 300
Chicago, IL 60640
Phone (773) 697-7333

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1831849660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 N RAVENSWOOD AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404579",
            "telephone_number": "773-697-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 N RAVENSWOOD AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404579",
            "telephone_number": "773-697-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MADELEINE",
        "middle_name": "MICHELLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "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 Jun 5, 2024; 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.