NPIMap

Organization Active NPI

Vitalize Home Therapy PLLC

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1053985374
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
VITALIZE HOME THERAPY PLLC
Practice address
5140 N Oakley Ave
Chicago, IL 60625-1847
Phone
(773) 573-4443
NPI assigned
May 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Karen Stanley, OTNPI 1316528698
Title
Managing Member/Owner
Phone
(773) 573-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

5140 N Oakley Ave
Chicago, IL 60625-1847

Mailing address

5140 N Oakley Ave
Chicago, IL 60625-1847
Phone (773) 573-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210706002012 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7416359070 Receives reassigned benefits from 5 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1053985374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251847",
            "telephone_number": "773-573-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251847",
            "telephone_number": "773-573-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALIZE HOME THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MANAGING MEMBER/OWNER",
        "authorized_official_telephone_number": "773-573-4443",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "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 May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.