Individual provider Active NPI

Nicole Esther Kovalevsky, OTD

  • Pediatric Occupational Therapist
  • Northbrook, IL
National Provider Identifier
1417610510
Registry record updated May 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
1901 Raymond Dr Ste 7
Northbrook, IL 60062-6739
Phone
(224) 216-2488
NPI assigned
Oct 16, 2021
Last updated
May 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

1901 Raymond Dr Ste 7
Northbrook, IL 60062-6739

Mailing address

2390 El Cid LN
Northbrook, IL 60062-7005

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cadence Physical Therapy Co Single Specialty CurrentSince Oct 30, 2023 Accepting new patients

Locations

1300 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 378-4970

333 W Dundee Rd
Buffalo Grove, IL 60089
Phone (847) 243-0355

Organizations & group practices 2

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": "1634342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1417610510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 EL CID LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 RAYMOND DR STE 7",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626739",
            "telephone_number": "224-216-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALEVSKY",
        "first_name": "NICOLE",
        "middle_name": "ESTHER",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-16",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 30, 2026; 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.