Individual provider Active NPI

Cristian Ramirez

  • Occupational Therapist
  • Niles, IL
National Provider Identifier
1174143465
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056013149 Issued in IL
Practice address
6631 N Milwaukee Ave
Niles, IL 60714-4416
Phone
(847) 647-7444
NPI assigned
Apr 16, 2020
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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 056013149 IL Primary

Addresses

Primary practice location

6631 N Milwaukee Ave
Niles, IL 60714-4416

Mailing address

2816 W Summerdale Ave Apt 2E
Chicago, IL 60625-3420
Phone (773) 990-9666

Other identifiers 1

IdentifierTypeStateIssuer
056013149OtherILOT LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Matrix Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240604000847 IL Practitioner - Occupational Therapist in Private Practice 8022550268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056013149ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Apr 22, 2024 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Apr 22, 2024 Accepting new patients

Locations

2155 W Pierce Ave
Chicago, IL 60622
Phone (773) 252-2066

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1174143465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 W SUMMERDALE AVE APT 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253420",
            "telephone_number": "773-990-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6631 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144416",
            "telephone_number": "847-647-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "CRISTIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056013149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "056013149",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Matrix",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Matrix",
            "address_1": "6631 N Milwaukee Ave",
            "city": "Niles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607144416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.