Active NPI
Leandra Rose Rodriguez, COTA
- Occupational Therapy Assistant
- Chicago, IL
National Provider Identifier
1174894711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057001657
- Practice address
- 222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808 - Phone
- (312) 416-3804
- Fax
- (866) 602-2700
- NPI assigned
- Jan 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 057001657 | IL | Primary |
Addresses
Primary practice location
222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808
Mailing address
2560 Leyden Ave
River Grove, IL 60171-1660
Phone (708) 426-3226
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 |
|---|---|---|---|
| 057001657 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326326400000",
"number": "1174894711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2560 LEYDEN AVE",
"city": "RIVER GROVE",
"state": "IL",
"postal_code": "601711660",
"telephone_number": "708-426-3226"
},
{
"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": "866-602-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "LEANDRA",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-12",
"last_updated": "2012-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057001657",
"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 Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.