Active NPI
Kimberly Lynn Anderson, MS, OTR/L
- Occupational Therapist
- Shorewood, IL
National Provider Identifier
1962413153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056006657
- Practice address
- 857 Center CT Unit D
Shorewood, IL 60431-8520 - Phone
- (815) 730-1818
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 056006657 | IL | |
| Occupational Therapist | 225X00000X | 056006657 | IL | Primary |
Addresses
Primary practice location
857 Center CT Unit D
Shorewood, IL 60431-8520
Mailing address
2732 Grand Ridge Cir
Aurora, IL 60503-5422
Phone (630) 988-4244
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056006657 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744848000000",
"number": "1962413153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2732 GRAND RIDGE CIR",
"city": "AURORA",
"state": "IL",
"postal_code": "605035422",
"telephone_number": "630-988-4244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "857 CENTER CT UNIT D",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604318520",
"telephone_number": "815-730-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KIMBERLY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2025-04-17",
"certification_date": "2025-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056006657",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056006657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.