Active NPI
McKenna Marlene Moss, MOT, OTR/L
- Pediatric Occupational Therapist
- Palatine, IL
National Provider Identifier
1073338935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 056.016326
- Practice address
- 887 E Wilmette Rd.
Suite B
Palatine, IL 60074-6495 - Phone
- (847) 907-9227
- NPI assigned
- Nov 18, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 056.016326 | IL | Primary |
Addresses
Primary practice location
887 E Wilmette Rd.
Suite B
Palatine, IL 60074-6495
Mailing address
515 Colonial CT.
Algonquin, IL 60102
Phone (857) 890-8240
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 |
|---|---|---|---|
| 056.016326 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1073338935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 COLONIAL CT.",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "60102",
"telephone_number": "857-890-8240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "887 E WILMETTE RD.",
"address_2": "SUITE B",
"city": "PALATINE",
"state": "IL",
"postal_code": "600746495",
"telephone_number": "847-907-9227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "MCKENNA",
"middle_name": "MARLENE",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-18",
"last_updated": "2024-11-18",
"certification_date": "2024-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056.016326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatine, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.