Active NPI
Lisa Kay Iffland, OTR
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1043753981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056-001297
- Practice address
- 2417 W Gladys Ave
Chicago, IL 60612-4806 - Phone
- (312) 733-8018
- Fax
- (773) 481-8892
- NPI assigned
- Nov 26, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056-001297 | IL | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 056-001297 | IL |
Addresses
Primary practice location
2417 W Gladys Ave
Chicago, IL 60612-4806
Mailing address
2417 W Gladys Ave
Chicago, IL 60612-4806
Phone (312) 733-8018
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 |
|---|---|---|---|
| 056-001297 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480118400000",
"number": "1043753981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 W GLADYS AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124806",
"telephone_number": "312-733-8018",
"fax_number": "773-481-8892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2417 W GLADYS AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124806",
"telephone_number": "312-733-8018",
"fax_number": "773-481-8892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFFLAND",
"first_name": "LISA",
"middle_name": "KAY",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-26",
"last_updated": "2016-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056-001297",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056-001297",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.