Individual provider Active NPI

Mallory Siska, OTD, OTR/L

  • Occupational Therapist
  • Orland Park, IL
National Provider Identifier
1285220848
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.013850 Issued in IL
Practice address
14225 S 95TH Ave Ste 453
Orland Park, IL 60462-2266
Phone
(708) 787-0952
NPI assigned
Dec 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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 056.013850 IL Primary

Addresses

Primary practice location

14225 S 95TH Ave Ste 453
Orland Park, IL 60462-2266

Mailing address

14225 S 95TH Ave Ste 453
Orland Park, IL 60462-2266
Phone (708) 787-0952

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
056.013850ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Childrens Therapy Occupational Therapist Past Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC PastSince Jun 1, 2022 Accepting new patients

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": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1285220848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14225 S 95TH AVE STE 453",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622266",
            "telephone_number": "708-787-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14225 S 95TH AVE STE 453",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622266",
            "telephone_number": "708-787-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISKA",
        "first_name": "MALLORY",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.