Individual provider Active NPI

Lori Vandellen, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1215289681
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056008195 Issued in IL
Practice address
1366 W Fullerton Ave
Chicago, IL 60614-2129
Phone
(773) 248-9300
NPI assigned
Oct 10, 2012
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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 056008195 IL Primary

Addresses

Primary practice location

1366 W Fullerton Ave
Chicago, IL 60614-2129

Mailing address

5219 N Saint Louis Ave
Chicago, IL 60625-4705

Other names 1

  • Lorraine Vandellen Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220617001635 IL Practitioner - Occupational Therapist in Private Practice 5698154888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

2155 W Pierce Ave
Chicago, IL 60622-1884
Phone (773) 917-8609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056008195ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jun 1, 2022 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Jun 1, 2022 Accepting new patients

Locations

2155 W Pierce Ave
Chicago, IL 60622
Phone (773) 252-2066

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, 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": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1215289681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 N SAINT LOUIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606254705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142129",
            "telephone_number": "773-248-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDELLEN",
        "first_name": "LORI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056008195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORRAINE",
            "last_name": "VANDELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 17, 2022; 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.