Individual provider Active NPI

Alexandra Rose Martin

  • Occupational Therapist
  • Oak Lawn, IL
National Provider Identifier
1245717834
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056077624 Issued in IL
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

Updated by the provider on Oct 1, 2024

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 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

Enrollment IDStateProvider typePAC IDDetails
I20211216001031 IL Practitioner - Occupational Therapist in Private Practice 8022409507 Reassigns benefits to 1 organization

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
Rci (WRS) LLCGroup PAC ID 5092624510, 325 clinicians

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

LicenseStateTypeSpecialty
056077624ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC. Current Accepting new patients
Rci (WRS), LLC. CurrentSince Nov 15, 2021 Accepting new patients
Rci (WRS), LLC CurrentSince Nov 15, 2021 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.

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.

Verify at the official NPI Registry.