Individual provider Active NPI

Cristine A Lieb, OTR

  • Pediatric Occupational Therapist
  • Joliet, IL
National Provider Identifier
1295936797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
56001163 Issued in IL
Practice address
212 Barney Dr
Joliet, IL 60435-5271
Phone
(815) 725-2194
Fax
(815) 725-5150
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 56001163 IL Primary

Addresses

Primary practice location

212 Barney Dr
Joliet, IL 60435-5271

Mailing address

212 Barney Dr
Joliet, IL 60435-5271
Phone (815) 725-2194

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
56001163ILMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295936797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 BARNEY DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355271",
            "telephone_number": "815-725-2194",
            "fax_number": "815-725-5150"
        },
        {
            "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",
            "fax_number": "815-725-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEB",
        "first_name": "CRISTINE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "56001163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.