Active NPI
Alexandra Rose Martin
- Occupational Therapist
- Oak Lawn, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056077624
- Practice address
- 4710 W 95TH St
Oak Lawn, IL 60453-2453 - Phone
- (708) 422-2960
- NPI assigned
- Jul 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056077624 | IL | Primary |
Addresses
Primary practice location
4710 W 95TH St
Oak Lawn, IL 60453-2453
Mailing address
2336 Tara Dr
Elgin, IL 60123-4936
Phone (847) 287-9302
Other practice location 1
11245 W Lincoln Hwy Ste 21
Mokena, IL 60448-8673
Phone (708) 719-4093
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Saint Louis University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4710 W 95TH St
Suite B6
Oak Lawn, IL 60453-2546
Phone (708) 422-2960
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056077624 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rci (WRS), LLC. | Current | Accepting new patients | |
| Rci (WRS), LLC. | Current | Accepting new patients | |
| Rci (WRS), LLC | Current | Accepting new patients | |
| Rush-Select Holdings, LLC. | Past | Accepting new patients |
Locations
11245 W Lincoln Hwy
Ste 21
Mokena, IL 60448
Phone (708) 719-4093
4710 W 95th St
Ste B6
Oak Lawn, IL 60453
Phone (708) 351-5286
9000 W College Pkwy
Palos Hills, IL 60465
Phone (618) 529-3201
826 W Touhy Ave
Park Ridge, IL 60068
Phone (847) 720-4165
Organizations & group practices 4
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.
-
- Physical Therapy Clinic/Center
- Mt Prospect, IL
- NPI 1417561655
-
- Physical Therapy Clinic/Center
- Mokena, IL
- NPI 1568160950
-
- Rehabilitation Clinic/Center
- Chicago, IL
- NPI 1043824287
-
- Physical Therapy Clinic/Center
- Mokena, IL
- NPI 1265387435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727740800000",
"number": "1245717834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2336 TARA DR",
"city": "ELGIN",
"state": "IL",
"postal_code": "601234936",
"telephone_number": "847-287-9302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4710 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532453",
"telephone_number": "708-422-2960"
}
],
"practiceLocations": [
{
"address_1": "11245 W Lincoln Hwy Ste 21",
"address_purpose": "LOCATION",
"city": "Mokena",
"state": "IL",
"postal_code": "604488673",
"country_code": "US",
"telephone_number": "708-719-4093",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "ALEXANDRA",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-26",
"last_updated": "2024-10-01",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056077624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.