Audrey Mullen, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056008765 Issued in IL

Practice address

1010 Fairway Dr
Freeport, IL 61032-6600

Phone

(815) 599-6340

NPI assigned

Jul 13, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1871015545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31488 MIDDLE CREEK RD",
            "city": "LANARK",
            "state": "IL",
            "postal_code": "610469039",
            "telephone_number": "815-499-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 FAIRWAY DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326600",
            "telephone_number": "815-599-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "AUDREY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-13",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056008765",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "4432",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Sophia Morgan, OT
• Angela Lee Mosley
• Susan Mote
• Michael J. Muise, MD
• Fadzanai Mukarakate
• Kelley Munda, MSED, NCC, LCPC
• Christopher Peter Murdakes, PHARMD.
• Judy A Murphy
• Mohannad Musa, D.D.S.
• Anthony Musso

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.