Kristine Louise Madura, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057003716 Issued in IL

Practice address

4239 N Oak Park Ave
Chicago, IL 60634-1410

Phone

(219) 614-8206

NPI assigned

Oct 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1124669148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 NEW YORK AVE",
            "city": "WHITING",
            "state": "IN",
            "postal_code": "463942145",
            "telephone_number": "219-614-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4239 N OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341410",
            "telephone_number": "219-614-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADURA",
        "first_name": "KRISTINE",
        "middle_name": "LOUISE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057003716",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "298567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristine.madura@genesishcc.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4239 N Oak Park Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606341410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adaku Ngozika Madubuko, APN,NP
• Obianuju Sandra Madueke-Laveaux, M.D.
• Ikenna Madueke, M.D., PH.D.
• Andrew Maduneme, MD,
• Brenda Madura, C.N.M.
• Madvitality Acupuncture & Wellness PLLC
• Venkatgiri S Mady, M.D.
• Mae'S Quality Home Care LLC
• Audrey D Mael, OTR/L
• David M Mael, M.D.

• All providers in Chicago, IL
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.