Individual provider Active NPI

Haley Fotopoulos, OTR/L

  • Occupational Therapist
  • Lake Zurich, IL
National Provider Identifier
1184269086
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.013329 Issued in IL
Practice address
795 N Rand Rd
Lake Zurich, IL 60047-2453
Phone
(847) 438-6100
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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 056.013329 IL Primary

Addresses

Primary practice location

795 N Rand Rd
Lake Zurich, IL 60047-2453

Mailing address

32036 Savannah Dr
Lakemoor, IL 60051-6113
Phone (574) 361-2455

Other names 1

  • Haley Kinsey Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030000589 IL Practitioner - Occupational Therapist in Private Practice 3779939657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

1000 Sunset Ridge Rd
Northbrook, IL 60062-4008
Phone (224) 300-7284

901 Angle Tarn
West Dundee, IL 60118-0045
Phone (224) 802-6020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.013329ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Occupational Therapist CurrentSince Sep 13, 2023 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Nov 11, 2024 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Nov 11, 2024 Accepting new patients

Locations

795 N Rand Rd
Lake Zurich, IL 60047
Phone (847) 438-6100

28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 413-5817

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 3

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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1184269086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32036 SAVANNAH DR",
            "city": "LAKEMOOR",
            "state": "IL",
            "postal_code": "600516113",
            "telephone_number": "574-361-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 N RAND RD",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600472453",
            "telephone_number": "847-438-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOTOPOULOS",
        "first_name": "HALEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "KINSEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Zurich, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.