Individual provider Active NPI

Peggy Ann Sallade, OT

  • Occupational Therapist
  • Plymouth, MI
National Provider Identifier
1992126635
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056003256 Issued in IL
Practice address
705 S Main St
Suite 220
Plymouth, MI 48170-2089
Phone
(773) 549-5294
NPI assigned
Dec 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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 056003256 IL Primary

Addresses

Primary practice location

705 S Main St
Suite 220
Plymouth, MI 48170-2089

Mailing address

16411 Patricia Ave
Tinley Park, IL 60477-1861
Phone (708) 257-9432

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address peg.sallade@medcarehmc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230327001143 IL Practitioner - Occupational Therapist in Private Practice 9537533914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

2800 Desplaines Ave
North Riverside, IL 60546-1851
Phone (708) 443-4217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056003256ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Feb 15, 2023 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Feb 15, 2023 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

2800 Desplaines Ave
Riverside, IL 60546
Phone (708) 443-4217

536 Old Howell Rd
Greenville, SC 29615
Phone (877) 508-3237

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1992126635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16411 PATRICIA AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771861",
            "telephone_number": "708-257-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S MAIN ST",
            "address_2": "SUITE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702089",
            "telephone_number": "773-549-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLADE",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-24",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056003256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peg.sallade@medcarehmc.com",
            "affiliation": "N",
            "address_1": "705 S Main St",
            "address_2": "Suite 220",
            "city": "Plymouth",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481702089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.