Active NPI
Nathalie Reisman
- Occupational Therapy Assistant
- Deerfield, IL
National Provider Identifier
1023436441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.000989
- Practice address
- 1601 Lake Cook Rd
Deerfield, IL 60015-5271 - Phone
- (847) 374-0500
- NPI assigned
- Apr 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 057.000989 | IL | Primary |
Addresses
Primary practice location
1601 Lake Cook Rd
Deerfield, IL 60015-5271
Mailing address
2645 Mulberry LN
Northbrook, IL 60062-5936
Other practice location 1
1000 Sunset Ridge Rd
Northbrook, IL 60062-4008
Phone (224) 235-4639
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
| License | State | Type | Specialty |
|---|---|---|---|
| 057.000989 | IL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Council for Jewish Elderly | Past | Accepting new patients |
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.
-
- Rehabilitation Clinic/Center
- Deerfield, IL
- NPI 1467012807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1023436441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2645 MULBERRY LN",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600625936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 LAKE COOK RD",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600155271",
"telephone_number": "847-374-0500"
}
],
"practiceLocations": [
{
"address_1": "1000 Sunset Ridge Rd",
"address_purpose": "LOCATION",
"city": "Northbrook",
"state": "IL",
"postal_code": "600624008",
"country_code": "US",
"telephone_number": "224-235-4639",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REISMAN",
"first_name": "NATHALIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-02",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.000989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Deerfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.