Individual provider Active NPI

Christine L. Wallner, COTA

  • Occupational Therapy Assistant
  • Chicago, IL
National Provider Identifier
1164643631
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808
Phone
(312) 416-3804
Fax
(312) 627-2700
NPI assigned
May 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X IL Primary

Addresses

Primary practice location

222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808

Mailing address

1231 Appaloosa Way
Bartlett, IL 60103-1873
Phone (630) 213-8540

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
057001703ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164643631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 APPALOOSA WAY",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031873",
            "telephone_number": "630-213-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RIVERSIDE PLZ",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065808",
            "telephone_number": "312-416-3804",
            "fax_number": "312-627-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLNER",
        "first_name": "CHRISTINE",
        "middle_name": "L.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": null,
            "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 Jul 8, 2007; 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.