Brenda Adolph
Individual provider Active NPI Occupational Therapist · Urbana, IL
NPI 1922487529 · NPPES record last updated May 28, 2015
Key facts
- NPI
- 1922487529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056011040 (IL)
- Practice address
- 611 W. Park St.
Urbana, IL 61801-2500 - Phone
- (217) 383-3800
- Fax
- (217) 383-3567
- NPI assigned
- May 28, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056011040 | IL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056011040 | IL | Yes |
Addresses
Primary practice location
611 W. Park St.
Urbana, IL 61801-2500
Mailing address
611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6941
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All providers in Urbana, IL · Occupational Therapist 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 28, 2015. 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.