Individual provider Active NPI

Kristin Paul, COTA/L

  • Pediatric Occupational Therapist
  • Chicago, IL
National Provider Identifier
1245596683
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
057-002725 Issued in NU
Practice address
4027 N Francisco Ave
#1S
Chicago, IL 60618-2601
Phone
(773) 263-6981
Fax
(773) 681-7233
NPI assigned
Apr 10, 2012
Last updated
Apr 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 057-002725 NU Primary

Addresses

Primary practice location

4027 N Francisco Ave
#1S
Chicago, IL 60618-2601

Mailing address

18210 Exchange Ave
Lansing, IL 60438-5905

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

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1245596683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18210 EXCHANGE AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604385905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 N FRANCISCO AVE",
            "address_2": "#1S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182601",
            "telephone_number": "773-263-6981",
            "fax_number": "773-681-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "KRISTIN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": "057-002725",
            "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 Apr 10, 2012; 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.