Eletta Harris

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.004001 Issued in IL

Practice address

16300 Wausau Ave
South Holland, IL 60473-2158

Phone

(708) 261-1111

NPI assigned

Jan 23, 2023

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

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1295440485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18527 HARWOOD AVE APT 2A",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303634",
            "telephone_number": "708-261-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 WAUSAU AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732158",
            "telephone_number": "708-261-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.004001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janis L Harding, MSCCC-LSP
• Myiesha Hardy
• Harmony House Cila
• Ollie Harris-Muse
• Bianca Harris, BS, CLS
• Melissa Harris, OTR
• Michelle Harris, M.D.
• Harvey Family Center
• Latouna Hayes
• Healing Empowering & Learning Professionals LLC

• Occupational Therapy Assistant in South Holland, IL
• Providers in South Holland, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.