Stephanie Carbajal, MSOT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

056.015981 Issued in IL

Practice address

212 Barney Dr
Joliet, IL 60435-5271

Phone

(815) 725-2194

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Easter Seals Joliet Region Inc.

  • Developmental Disabilities Clinic/Center
  • Joliet, IL
  • NPI 1992708960
  NPD (past)

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1275375560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24525 SHAWNEE LN",
            "city": "MANHATTAN",
            "state": "IL",
            "postal_code": "604421447",
            "telephone_number": "708-800-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 BARNEY DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355271",
            "telephone_number": "815-725-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBAJAL",
        "first_name": "STEPHANIE",
        "credential": "MSOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056.015981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daryl Scott Caneva, DPM
• Roberto Caneva
• Tara Cannella
• Daniel Capparelli
• Cagney Damien Cappelli, MA,LCPC,CADC,MISA II
• Lucia Cardenas Navarro, QMHP
• Cardinal Sleep Centers of America LLP
• Cardiology Associates of Northern Illinois
• Cardiology Associates of Northern Illinois
• Cardiology Associates of Northern Illinois

• All providers in Joliet, IL
• Pediatric Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.