NPIMap

Organization Active NPI

Optimal Potential, Inc.

  • Occupational Therapist
  • Dolton, IL
National Provider Identifier
1376677153
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
OPTIMAL POTENTIAL, INC.
Practice address
14920 Evers St
Dolton, IL 60419-2602
Phone
(708) 738-9423
NPI assigned
Mar 15, 2007
Last updated
May 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Authorized official

Name
Fetima DavisNPI 1265566046
Title
Occupational Therapist
Phone
(708) 738-9423

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

14920 Evers St
Dolton, IL 60419-2602

Mailing address

14920 Evers St
Dolton, IL 60419-2602
Phone (708) 738-9423

National Provider Directory

National Provider Directory

Locations

1223 W 87th St
Chicago, IL 60620
Phone (773) 238-6489

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1376677153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14920 EVERS ST",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192602",
            "telephone_number": "708-738-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14920 EVERS ST",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192602",
            "telephone_number": "708-738-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL POTENTIAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "FETIMA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "708-738-9423"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dolton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.