Active NPI
Kailan Nicole Kathryn Paul, OTR/L
- Occupational Therapist
- Frankfort, IL
National Provider Identifier
1063974343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.012526
- Practice address
- 21000 S. Frankfort Square Road, Suite D
Frankfort, IL 60423 - Phone
- (815) 469-1500
- Fax
- (815) 220-5619
- NPI assigned
- Apr 4, 2019
- Reactivated
- Nov 18, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 056.012526 | IL | |
| Occupational Therapist | 225X00000X | 056.012526 | IL | Primary |
Addresses
Primary practice location
21000 S. Frankfort Square Road, Suite D
Frankfort, IL 60423
Mailing address
21000 Frankfort Square Road Ste D (Westside Children'S
Frankfort, IL 60423
Phone (815) 469-1500
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 |
|---|---|---|---|
| 056.012526 | IL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westside Childrens Therapy | Occupational Therapist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574035200000",
"number": "1063974343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21000 FRANKFORT SQUARE ROAD STE D (WESTSIDE CHILDREN'S",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "60423",
"telephone_number": "815-469-1500",
"fax_number": "815-220-5619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21000 S. FRANKFORT SQUARE ROAD, SUITE D",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "60423",
"telephone_number": "815-469-1500",
"fax_number": "815-220-5619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "KAILAN",
"middle_name": "NICOLE KATHRYN",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-04",
"last_updated": "2019-11-18",
"deactivation_date": "2019-11-07",
"reactivation_date": "2019-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056.012526",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.012526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frankfort, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.