Samantha Piasny
Individual provider Active NPI Occupational Therapy Assistant · Fox River Grove, IL
NPI 1265085484 · NPPES record last updated Jul 17, 2019
Key facts
- NPI
- 1265085484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 057005177 (IL)
- Practice address
- 1009 Il Route 22 Ste 1
Fox River Grove, IL 60021-1998 - Phone
- (847) 462-8707
- NPI assigned
- Jul 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057005177 | IL | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057005177 | IL | Yes |
Addresses
Primary practice location
1009 Il Route 22 Ste 1
Fox River Grove, IL 60021-1998
Mailing address
1009 Il Route 22 Ste 1
Fox River Grove, IL 60021-1998
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HMM00004 | Medicaid | IL |
Other providers in Fox River Grove, IL
- Pain & Vascular Institute PLLC
- Maya Patel
- Andrew J Pawlak
- Vini Pearlman
- Pediatric Associates of Barrington, S.C.
- Nicole Anne Poloski
- John R Reader
- Michael Reilly
- Rejuvenate Acupuncture, Herb & Massage
- Megan Riley
All providers in Fox River Grove, IL · Occupational Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.