SHELLY GREENAWALT (NPI# 1770964678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770964678 |
| Entity Type | Individual |
| Full Name | SHELLY GREENAWALT |
| Credential | COTA/L |
| Practice Address |
500 Asbury Ave Evanston IL 60202-2724 |
| Mailing Address |
925 S Semoran Blvd Ste 110a Winter Park FL 32792-5313 |
| Practice Telephone | 8473163320 |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 224Z00000X | Occupational Therapy Assistant | 3049 | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 224Z00000X | Occupational Therapy Assistant | 2258 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 224Z00000X | Occupational Therapy Assistant | OTA.04748 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 224Z00000X | Occupational Therapy Assistant | 057.003950 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
500 ASBURY AVE |
| City | EVANSTON |
| State | IL |
| Zip Code | 60202-2724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376537670 | Resurrection Senior Services | Skilled Nursing Facility | 500 Asbury Ave, Evanston, IL 60202-2724 | 2005-09-01 |
| 1063021731 | Aimee Jane Aledia Pena | Physical Therapist | 500 Asbury Ave, Evanston, IL 60202-2724 | 2020-07-28 |
| 1740827914 | Melissa Haberstroh | Social Worker | 500 Asbury Ave, Evanston, IL 60202-2724 | 2019-12-05 |
| 1770070013 | Mary Murad | Nurse Practitioner | 500 Asbury Ave, Evanston, IL 60202-2724 | 2018-04-20 |
| 1598137895 | Evanston Skilled Nursing Facility LLC | Skilled Nursing Facility | 500 Asbury Ave, Evanston, IL 60202-2724 | 2015-10-26 |
| 1770907230 | Esther Sault | Nurse Practitioner | 500 Asbury Ave, Evanston, IL 60202-2724 | 2014-02-04 |
| 1427485838 | Ka Kei Lon | Occupational Therapist | 500 Asbury Ave, Evanston, IL 60202-2724 | 2013-09-30 |
| 1194038711 | Pedro Juan Gonzalez | Physical Medicine & Rehabilitation | 500 Asbury Ave, Evanston, IL 60202-2724 | 2010-07-24 |
| 1891011615 | Grove of Evanston LLC | Skilled Nursing Facility | 500 Asbury Ave, Evanston, IL 60202-2724 | 2010-04-19 |
| 1063673481 | Ranjeet Singh | Physical Medicine & Rehabilitation | 500 Asbury Ave, Evanston, IL 60202-2724 | 2008-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548889496 | Ktsmiles, Inc | Clinic/Center | 2408 Main Street, Evanston, IL 60202 | 2020-04-10 |
| 1831751163 | Dorcas Matowe | Marriage & Family Therapist | The Family Institute, 618 Library Place, Evanston, IL 60202 | 2019-07-08 |
| 1457847170 | Lilah Handler | Social Worker | 905 Forest Ave, Apt 1, Evanston, IL 60202 | 2018-07-05 |
| 1528574472 | Jessica Kubacki | Developmental Therapist | 535 Hinman Ave Apt F3, Evanston, IL 60202 | 2017-12-14 |
| 1376075853 | Lisa Meyerson Acupuncture | Acupuncturist | 1234 Sherman Avenue, Lighthouse Yoga and Acupuncture, Evanston, IL 60202 | 2017-04-03 |
| 1427597368 | Lillian Obucina Dds PC | Dentist | 111 North Wabash, Suite 1522, Chicago, IL 60202 | 2017-02-13 |
| 1184176893 | Amelia Willcox | Speech-Language Pathologist | 620 Sheridan Square, Apartment 1, Evanston, IL 60202 | 2016-10-28 |
| 1831547785 | Thomas Hagerty Jr. | Pharmacist | 2491 W Howard St, Evanston, IL 60202 | 2016-06-01 |
| 1013361948 | Autism Hope Support | In Home Supportive Care | 815 Seward Apt. 1s, Evanston, IL 60202 | 2016-04-18 |
| 1215302625 | Preferred Dentistry Associates, LLC | Dentist | 1029 Howard Street, Evanston, IL 60202 | 2015-12-10 |
| Find all providers in zip 60202 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073901922 | Jolene Gembara | Occupational Therapy Assistant | 910 Grey Ave, Evanston, IL 60202-1511 | 2014-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940886 | Kathleen Pumo | Occupational Therapy Assistant | 300 W 22nd St, Lombard, IL 60148-5417 | 2020-10-26 |
| 1093314593 | Melissa Eileen Suermann | Occupational Therapy Assistant | 300 S Station Rd, Glen Carbon, IL 62034-2739 | 2020-10-26 |
| 1265049746 | Lauren Bryant | Occupational Therapy Assistant | 17042 Wausau Ave, South Holland, IL 60473-3352 | 2020-09-28 |
| 1992312631 | Agnieszka Wanda Bis | Occupational Therapy Assistant | 110 W Schaumburg Rd, Streamwood, IL 60107-1459 | 2020-09-27 |
| 1093322091 | Aven Dones | Occupational Therapy Assistant | 2600 W Compass Dr, Glenview, IL 60026 | 2020-09-24 |
| 1326651894 | Laverne Reese | Occupational Therapy Assistant | 150 S Durkin Dr Apt, Springfield, IL 62704-1151 | 2020-08-25 |
| 1326650235 | Cheryl Annette Perrilles | Occupational Therapy Assistant | 5124 S Alaska Rd, Peoria, IL 61607-9541 | 2020-08-21 |
| 1003426487 | Allyx Underwood | Occupational Therapy Assistant | 111 S Homer St, Princeton, IL 61356-1850 | 2020-07-31 |
| 1023635364 | Crystal Mary Dirks | Occupational Therapy Assistant | 211 75th St, Burr Ridge, IL 60527 | 2020-07-02 |
| 1508483991 | Latika Kemp | Occupational Therapy Assistant | 7246 S. King Dr., Chicago, IL 60619-1726 | 2020-07-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SHELLY GREENAWALT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.