Individual provider Active NPI

Tiffany Stella, MOT, OTR/L

  • Occupational Therapist
  • Antioch, IL
National Provider Identifier
1114438330
Registry record updated Oct 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056012174 Issued in IL
Practice address
311 W Depot St Ste N
Antioch, IL 60002-1500
Phone
(847) 838-8085
NPI assigned
Oct 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2017

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 056012174 IL Primary

Addresses

Primary practice location

311 W Depot St Ste N
Antioch, IL 60002-1500

Mailing address

311 W Depot St Ste N
Antioch, IL 60002-1500

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

LicenseStateTypeSpecialty
056012174ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope'S Playground Pediatric Therapy, Inc. Past Accepting new patients
Hope'S Playground Pediatric Therapy, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1508025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508025600000",
    "number": "1114438330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W DEPOT ST STE N",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W DEPOT ST STE N",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021500",
            "telephone_number": "847-838-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLA",
        "first_name": "TIFFANY",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-15",
        "last_updated": "2017-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2017; 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.