Active NPI
Lorinda Golab, COTA/L
- Occupational Therapy Assistant
- Chicago, IL
National Provider Identifier
1053804880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.005589
- Practice address
- 4812 S Avers Ave
Chicago, IL 60632-3627 - Phone
- (773) 317-1315
- NPI assigned
- Jun 6, 2018
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-44844 | IL | |
| Occupational Therapy Assistant | 224Z00000X | 057.005589 | IL | Primary |
Addresses
Primary practice location
4812 S Avers Ave
Chicago, IL 60632-3627
Mailing address
1308 Jenna Dr Unit a
South Elgin, IL 60177-3425
Phone (773) 317-1315
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 |
|---|---|---|---|
| RBT-17-44844 | IL | MD | Behavior Technician |
| 057.005589 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622678400000",
"number": "1053804880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 JENNA DR UNIT A",
"city": "SOUTH ELGIN",
"state": "IL",
"postal_code": "601773425",
"telephone_number": "773-317-1315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4812 S AVERS AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606323627",
"telephone_number": "773-317-1315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLAB",
"first_name": "LORINDA",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-06",
"last_updated": "2021-06-03",
"certification_date": "2021-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-17-44844",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.005589",
"primary": true
}
],
"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 Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.