Individual provider Active NPI

Donna Melody, COTA/L

  • Pediatric Occupational Therapist
  • Lincolnwood, IL
National Provider Identifier
1083055966
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
057003576 Issued in IL
Practice address
6729 N Kilpatrick Ave
Lincolnwood, IL 60712-3309
Phone
(773) 263-6981
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 057003576 IL Primary

Addresses

Primary practice location

6729 N Kilpatrick Ave
Lincolnwood, IL 60712-3309

Mailing address

12822 S Ponderosa Dr
Palos Heights, IL 60463-1934

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
057003576ILMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1083055966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12822 S PONDEROSA DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6729 N KILPATRICK AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123309",
            "telephone_number": "773-263-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELODY",
        "first_name": "DONNA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "057003576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.