Active NPI
Sydney Gruntler, OTR/L
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1275161903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.013508
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.013508 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Let's Grow, Inc. | Current | Accepting new patients | |
| Kids on the Grow | Occupational Therapist | Current | 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.