Kristin Romero, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Wood River, IL

NPI 1003748534 · NPPES record last updated Jun 1, 2026

Key facts

NPI
1003748534
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057.002922 (IL)
Practice address
849 Lewis Ave
Wood River, IL 62095-2323
Phone
(618) 610-9419
NPI assigned
Jun 1, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
057.002922ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
224Z00000X 057.002922 IL Yes

Addresses

Primary practice location

849 Lewis Ave
Wood River, IL 62095-2323

Mailing address

849 Lewis Ave
Wood River, IL 62095-2323

Other providers in Wood River, IL

All providers in Wood River, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.