Active NPI
Mariene Italia, OTR/L
- Occupational Therapist
- Glenview, IL
National Provider Identifier
1154632099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.003013
- Practice address
- 3703 W Lake Ave Ste 200
Glenview, IL 60026-1266 - Phone
- (847) 998-1188
- NPI assigned
- Jun 25, 2010
- 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 | 056.003013 | IL | Primary |
Addresses
Primary practice location
3703 W Lake Ave Ste 200
Glenview, IL 60026-1266
Mailing address
1611 Cindy LN
Sandwich, IL 60548-2552
Phone (815) 786-8426
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.003013 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Therapeutics LTD | Occupational Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- North Riverside, IL
- NPI 1699094102
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277424000000",
"number": "1154632099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 CINDY LN",
"city": "SANDWICH",
"state": "IL",
"postal_code": "605482552",
"telephone_number": "815-786-8426",
"fax_number": "815-786-1621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3703 W LAKE AVE STE 200",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600261266",
"telephone_number": "847-998-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITALIA",
"first_name": "MARIENE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-25",
"last_updated": "2010-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.003013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.