Individual provider Active NPI

Katarina Kozomora, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1205347382
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056010967 Issued in IL
Practice address
1325 N Astor St
Chicago, IL 60610-2343
Phone
(312) 371-2773
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 056010967 IL Primary

Addresses

Primary practice location

1325 N Astor St
Chicago, IL 60610-2343

Mailing address

1325 N Astor St
Chicago, IL 60610-2343
Phone (312) 371-2773

Other practice location 1

1957 W Dickens Ave
Chicago, IL 60614-3934
Phone (773) 789-9640

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

LicenseStateTypeSpecialty
056010967ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205347382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 N ASTOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102343",
            "telephone_number": "312-371-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 N ASTOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102343",
            "telephone_number": "312-371-2773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1957 W Dickens Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606143934",
            "country_code": "US",
            "telephone_number": "773-789-9640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZOMORA",
        "first_name": "KATARINA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056010967",
            "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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.