Individual provider Active NPI

Hetal Dutia, OTR

  • Occupational Therapist
  • Orland Park, IL
National Provider Identifier
1205044690
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056007045 Issued in IL
Practice address
16170 Kingsport Rd
Orland Park, IL 60467-5602
Phone
(708) 349-6544
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

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 Therapist 225X00000X 056007045 IL Primary

Addresses

Primary practice location

16170 Kingsport Rd
Orland Park, IL 60467-5602

Mailing address

483 Blodgett CT
Naperville, IL 60565-4330
Phone (708) 349-6544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112001434 IL Practitioner - Occupational Therapist in Private Practice 5799117834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056007045ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Therapy & Consultation, Inc. Occupational Therapist Past Accepting new patients

Organizations & group practices 1

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205044690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 BLODGETT CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605654330",
            "telephone_number": "708-349-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16170 KINGSPORT RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675602",
            "telephone_number": "708-349-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTIA",
        "first_name": "HETAL",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056007045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, 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.
  • 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.