Individual provider Active NPI

Vivian Ann Purnell, OTR/L

  • Occupational Therapist
  • Homewood, IL
National Provider Identifier
1962725903
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-001009 Issued in IL
Practice address
940 Maple Rd
Homewood, IL 60430-2061
Phone
(708) 799-0244
Fax
(708) 799-1505
NPI assigned
Mar 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056-001009 IL Primary

Addresses

Primary practice location

940 Maple Rd
Homewood, IL 60430-2061

Mailing address

940 Maple Rd
Homewood, IL 60430-2061
Phone (708) 799-0244

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

State licenses

LicenseStateTypeSpecialty
056-001009ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1962725903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 MAPLE RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302061",
            "telephone_number": "708-799-0244",
            "fax_number": "708-799-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 MAPLE RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302061",
            "telephone_number": "708-799-0244",
            "fax_number": "708-799-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURNELL",
        "first_name": "VIVIAN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-001009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.