Dirk Anderson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.011899 Issued in IL

Practice address

2534 E Lincoln Hwy
New Lenox, IL 60451-9712

Phone

(815) 462-9420

Fax

(815) 462-9421

NPI assigned

Mar 24, 2017

Last updated

Jul 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Athletic and Therapeutic Institute of Bourbonnais, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Bourbonnais, IL
  • NPI 1861503542
  Medicare reassignment NPD
• Athletic and Therapeutic Institute of Bourbonnais, LLC

  • Durable Medical Equipment & Medical Supplies
  • Columbia, IL
  • NPI 1124766696

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1891226460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 E LINCOLN HWY",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519712",
            "telephone_number": "815-462-9420",
            "fax_number": "815-462-9421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11947 S Harlem Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "604631482",
            "country_code": "US",
            "telephone_number": "708-361-7929",
            "fax_number": "708-361-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DIRK",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.011899",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Altabakhi
• Jamie Nicole Alvarado
• American Drug Stores LLC (Osco Drug #3178)
• American Drug Stores LLC (Osco Drug #3776)
• Amanda Michelle Amos
• Anesthesia Advocates, PC
• Ann Marie Taylor
• Anointed Hands Physical Therapy and Fitness Center
• Arg Therapy & Consulting
• Nathan Eugene Armbruster, PHARMD

• Occupational Therapist in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.