Active NPI
Olivia Kolomiyets
- Pediatric Occupational Therapist
- Northbrook, IL
National Provider Identifier
1306376413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 056011997
- Practice address
- 634 Academy Dr
Northbrook, IL 60062-2421 - Phone
- (224) 616-5439
- NPI assigned
- Jun 13, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 056011997 | IL | Primary |
Addresses
Primary practice location
634 Academy Dr
Northbrook, IL 60062-2421
Mailing address
6085 Sweetbay Dr
North Royalton, OH 44133-3178
Phone (440) 212-3297
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056011997 | Other | IL | ILLINOIS |
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 |
|---|---|---|---|
| 056011997 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497312000000",
"number": "1306376413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6085 SWEETBAY DR",
"city": "NORTH ROYALTON",
"state": "OH",
"postal_code": "441333178",
"telephone_number": "440-212-3297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 ACADEMY DR",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622421",
"telephone_number": "224-616-5439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLOMIYETS",
"first_name": "OLIVIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-13",
"last_updated": "2017-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056011997",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS",
"identifier": "056011997",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.