Active NPI
Tiffany Kim, OTR/L
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1336769603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.013471
- Practice address
- 5888 N Ridge Ave
Chicago, IL 60660-3450 - Phone
- (773) 769-2626
- NPI assigned
- Apr 16, 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 | 056.013471 | IL | Primary |
Addresses
Primary practice location
5888 N Ridge Ave
Chicago, IL 60660-3450
Mailing address
314 English Oak LN
Streamwood, IL 60107-3393
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 |
|---|---|---|---|
| 056.013471 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586995200000",
"number": "1336769603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 ENGLISH OAK LN",
"city": "STREAMWOOD",
"state": "IL",
"postal_code": "601073393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5888 N RIDGE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606603450",
"telephone_number": "773-769-2626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TIFFANY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-16",
"last_updated": "2020-04-16",
"certification_date": "2020-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.013471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.