Individual provider Active NPI

Sydney Gruntler, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1275161903
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.013508 Issued in IL
Practice address
2157 N Damen Ave Ste 2C
Chicago, IL 60647-6916
Phone
(773) 278-4769
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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 056.013508 IL Primary

Addresses

Primary practice location

2157 N Damen Ave Ste 2C
Chicago, IL 60647-6916

Mailing address

2644 N Sacramento Ave
Chicago, IL 60647-1714
Phone (317) 503-5077

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

State licenses

LicenseStateTypeSpecialty
056.013508ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Let's Grow, Inc. CurrentSince Jun 30, 2024 Accepting new patients
Kids on the Grow Occupational Therapist CurrentSince Jul 1, 2022 Accepting new patients

Locations

2157 N Damen Ave
Ste 2C
Chicago, IL 60647
Phone (773) 278-4769

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1275161903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2644 N SACRAMENTO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471714",
            "telephone_number": "317-503-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 N DAMEN AVE STE 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606476916",
            "telephone_number": "773-278-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNTLER",
        "first_name": "SYDNEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013508",
            "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 Mar 30, 2020; 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.