Active NPI
Hurube Debela-Sledge
- Occupational Therapy Assistant
- Chicago, IL
National Provider Identifier
1114284627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2298
- Practice address
- 7334 S University Ave
Chicago, IL 60619-2018 - Phone
- (562) 256-7550
- Fax
- (562) 256-7540
- NPI assigned
- Apr 20, 2012
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2298 | CA | Primary |
Addresses
Primary practice location
7334 S University Ave
Chicago, IL 60619-2018
Mailing address
7334 S University Ave
Chicago, IL 60619-2018
Phone (562) 256-7550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2298 | Medicaid | CA |
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 |
|---|---|---|---|
| 2298 | CA | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334880000000",
"number": "1114284627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7334 S UNIVERSITY AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606192018",
"telephone_number": "562-256-7550",
"fax_number": "562-256-7540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7334 S UNIVERSITY AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606192018",
"telephone_number": "562-256-7550",
"fax_number": "562-256-7540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBELA-SLEDGE",
"first_name": "HURUBE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-20",
"last_updated": "2012-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "2298",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2298",
"state": "CA"
}
],
"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 Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.