Active NPI
Stephanie Itani, MOTR/L
- Occupational Therapist
- Chicago Ridge, IL
National Provider Identifier
1013395508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.012715
- Practice address
- 10300 Southwest Hwy
Chicago Ridge, IL 60415-1426 - Phone
- (708) 717-6141
- NPI assigned
- May 15, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.012715 | IL | Primary |
Addresses
Primary practice location
10300 Southwest Hwy
Chicago Ridge, IL 60415-1426
Mailing address
7358 Lincoln Ave
Lincoln, IL 60712
Phone (847) 983-3750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1920 W Potomac Ave
Chicago, IL 60622-3149
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.012715 | IL | MD | Occupational Therapist |
Organizations & group practices 1
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.
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- Physical Therapy Clinic/Center
- Chicago, IL
- NPI 1215763206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651104000000",
"number": "1013395508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7358 LINCOLN AVE",
"city": "LINCOLN",
"state": "IL",
"postal_code": "60712",
"telephone_number": "847-983-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10300 SOUTHWEST HWY",
"city": "CHICAGO RIDGE",
"state": "IL",
"postal_code": "604151426",
"telephone_number": "708-717-6141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITANI",
"first_name": "STEPHANIE",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-15",
"last_updated": "2022-04-28",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.012715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.