Individual provider Active NPI

Aleksandr Vernik, COTA/L

  • Occupational Therapy Assistant
  • Niles, IL
National Provider Identifier
1043852841
Registry record updated Oct 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057005257 Issued in IL
Practice address
9777 N Greenwood Ave
Niles, IL 60714-1002
Phone
(847) 967-7000
NPI assigned
Oct 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057005257 IL Primary

Addresses

Primary practice location

9777 N Greenwood Ave
Niles, IL 60714-1002

Mailing address

1550 Sandpebble Dr Apt 212
Wheeling, IL 60090-5921
Phone (847) 361-1216

Other names 1

  • Alexander Vernik Other name

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

LicenseStateTypeSpecialty
057005257ILMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570924800000",
    "number": "1043852841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 SANDPEBBLE DR APT 212",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600905921",
            "telephone_number": "847-361-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 N GREENWOOD AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141002",
            "telephone_number": "847-967-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNIK",
        "first_name": "ALEKSANDR",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-13",
        "last_updated": "2019-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057005257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDER",
            "last_name": "VERNIK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.