Active NPI
Lisa Koffinke, OTR/L
- Occupational Therapist
- Aurora, IL
National Provider Identifier
1326652157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056002290
- Practice address
- 75 Executive Dr Ste 103
Aurora, IL 60504-8150 - Phone
- (800) 974-4378
- Fax
- (630) 515-1536
- NPI assigned
- Aug 31, 2020
- Last updated
- Aug 31, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056002290 | IL | Primary |
Addresses
Primary practice location
75 Executive Dr Ste 103
Aurora, IL 60504-8150
Mailing address
24014 W Renwick Rd Ste F
Plainfield, IL 60544-8708
Phone (800) 974-4378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1217 State St
Suite B1
Lemont, IL 60439-4419
Phone (800) 974-4378
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056002290 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT Holdings LLC | Occupational Therapist | Current | Accepting new patients |
| DPT Holdings PLLC | Occupational Therapist | Past | Accepting new patients |
Locations
75 Executive Dr
Ste 103
Aurora, IL 60504
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1326652157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24014 W RENWICK RD STE F",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605448708",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 EXECUTIVE DR STE 103",
"city": "AURORA",
"state": "IL",
"postal_code": "605048150",
"telephone_number": "800-974-4378",
"fax_number": "630-515-1536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOFFINKE",
"first_name": "LISA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-31",
"last_updated": "2020-08-31",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056002290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.