Individual provider Active NPI

Elizabeth E Wernsman, DT

  • Developmental Therapist
  • Lockport, IL
National Provider Identifier
1881816486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
EW69311098P Issued in IL
Practice address
16749 W Grace St
Lockport, IL 60441-7659
Phone
(815) 351-8622
Fax
(815) 836-8612
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 EW69311098P IL Primary

Addresses

Primary practice location

16749 W Grace St
Lockport, IL 60441-7659

Mailing address

16749 W Grace St
Lockport, IL 60441-7659
Phone (815) 351-8622

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
EW69311098PILMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881816486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16749 W GRACE ST",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604417659",
            "telephone_number": "815-351-8622",
            "fax_number": "815-836-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16749 W GRACE ST",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604417659",
            "telephone_number": "815-351-8622",
            "fax_number": "815-836-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNSMAN",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "credential": "DT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "EW69311098P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.