Individual provider Active NPI

Lynanne Macdonald, OTR/L

  • Occupational Therapist
  • Arlington Heights, IL
National Provider Identifier
1912369000
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.012039 Issued in IL
Practice address
1835 W Central Rd
Arlington Heights, IL 60005-2410
Phone
(847) 870-7711
NPI assigned
Mar 28, 2016
Last updated
Feb 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 104956 MN
Occupational Therapist 225X00000X 056.012039 IL Primary

Addresses

Primary practice location

1835 W Central Rd
Arlington Heights, IL 60005-2410

Mailing address

1265 N Sterling Ave Unit 105
Palatine, IL 60067-1945
Phone (952) 836-6543

Other practice location 1

711 W Maude Ave
Arlington Heights, IL 60004-3729
Phone (847) 268-3799

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.012039ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1912369000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 N STERLING AVE UNIT 105",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600671945",
            "telephone_number": "952-836-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052410",
            "telephone_number": "847-870-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 W Maude Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600043729",
            "country_code": "US",
            "telephone_number": "847-268-3799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "LYNANNE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104956",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.012039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2021; 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.