Individual provider Active NPI

Kaitlyn Nicole Wrenn, MOT, OTR/L

  • Occupational Therapist
  • Joliet, IL
National Provider Identifier
1194556175
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.015076 Issued in IL
Practice address
333 Madison St
Joliet, IL 60435-8200
Phone
(815) 725-7133
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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 056.015076 IL Primary

Addresses

Primary practice location

333 Madison St
Joliet, IL 60435-8200

Mailing address

18646 Poplar Ave
Homewood, IL 60430-3846
Phone (708) 954-7122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903000262 IL Practitioner - Occupational Therapist in Private Practice 8224577416 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.015076ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jul 20, 2024 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jul 20, 2024 Accepting new patients

Locations

550 Kildeer Dr
Bolingbrook, IL 60440
Phone (630) 634-5044

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1194556175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18646 POPLAR AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303846",
            "telephone_number": "708-954-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MADISON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358200",
            "telephone_number": "815-725-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRENN",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.015076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.