Active NPI
Carly Kukish, MOT
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1124448642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.011736
- Practice address
- 929 W Foster Ave
Chicago, IL 60640-1491 - Phone
- (773) 433-1800
- NPI assigned
- Apr 23, 2014
- 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 Therapist | 225X00000X | 056.011736 | IL | Primary |
Addresses
Primary practice location
929 W Foster Ave
Chicago, IL 60640-1491
Mailing address
1937 W Diversey Pkwy Apt 2E
Chicago, IL 60614-7844
Phone (215) 896-4087
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 |
|---|---|---|---|
| 056.011736 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1124448642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1937 W DIVERSEY PKWY APT 2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606147844",
"telephone_number": "215-896-4087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 W FOSTER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606401491",
"telephone_number": "773-433-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUKISH",
"first_name": "CARLY",
"name_prefix": "Ms.",
"credential": "MOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-23",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.011736",
"primary": true
}
],
"identifiers": [],
"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 Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.