Active NPI
Kelli Simic, OT
- Occupational Therapist
- Lincolnwood, IL
National Provider Identifier
1407800923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056-006512
- Practice address
- 7126 N Lincoln Ave
Lincolnwood, IL 60712-2234 - Phone
- (847) 676-5979
- NPI assigned
- May 20, 2006
- Last updated
- Aug 28, 2007
- 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 | 056-006512 | IL | Primary |
Addresses
Primary practice location
7126 N Lincoln Ave
Lincolnwood, IL 60712-2234
Mailing address
8930 Waukegan Rd
Suite 200 - Attn: Raquel Leon
Morton Grove, IL 60053-2126
Phone (847) 324-3976
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056-006512 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1407800923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8930 WAUKEGAN RD",
"address_2": "SUITE 200 - ATTN: RAQUEL LEON",
"city": "MORTON GROVE",
"state": "IL",
"postal_code": "600532126",
"telephone_number": "847-324-3976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7126 N LINCOLN AVE",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607122234",
"telephone_number": "847-676-5979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMIC",
"first_name": "KELLI",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056-006512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincolnwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.