Individual provider Active NPI

Kendra Pollizze, OT

  • Occupational Therapist
  • Park Ridge, IL
National Provider Identifier
1104872076
Registry record updated Oct 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-006494 Issued in IL
Practice address
800 Devon Ave
Park Ridge, IL 60068-4760
Phone
(847) 292-4710
Fax
(847) 292-4903
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056-006494 IL Primary

Addresses

Primary practice location

800 Devon Ave
Park Ridge, IL 60068-4760

Mailing address

800 Devon Ave
Park Ridge, IL 60068-4760
Phone (847) 292-4710

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-006494ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255046400000",
    "number": "1104872076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 DEVON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684760",
            "telephone_number": "847-292-4710",
            "fax_number": "847-292-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 DEVON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684760",
            "telephone_number": "847-292-4710",
            "fax_number": "847-292-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLIZZE",
        "first_name": "KENDRA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-006494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; 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.