Bri Tracy, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Rushville, IL
NPI 1891920104 · NPPES record last updated May 16, 2009
Key facts
- NPI
- 1891920104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 057003062 (IL)
- Practice address
- 238 S Congress St
Rushville, IL 62681-1465 - Phone
- (217) 322-4321
- NPI assigned
- May 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057003062 | IL | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057003062 | IL | Yes |
Addresses
Primary practice location
238 S Congress St
Rushville, IL 62681-1465
Mailing address
7720 Hickory Rd
Virginia, IL 62691-8742
Other providers in Rushville, IL
- Kerstin Marie Stitt
- Marguerite Simonne Taillefer
- Lori Ann Thomas
- Quintin Thurman
- Abdi Y Tinwalla
- Sara Trimble
- Amit Unnadkat
- Veronica Williams
- Catherine J Wilson
- Susan Wilson
All providers in Rushville, IL · Occupational Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.