Active NPI
Taylor Coblentz
- Occupational Therapist
- Buffalo Grove, IL
National Provider Identifier
1417678996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.014826
- Practice address
- 500 McHenry Rd
Buffalo Grove, IL 60089-1705 - Phone
- (847) 532-3492
- NPI assigned
- Sep 5, 2022
- Last updated
- Sep 5, 2022
- 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 | 056.014826 | IL | Primary |
Addresses
Primary practice location
500 McHenry Rd
Buffalo Grove, IL 60089-1705
Mailing address
2831 Northampton Dr Apt 104
Rolling Meadows, IL 60008-3367
Phone (414) 510-7981
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.014826 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662336000000",
"number": "1417678996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2831 NORTHAMPTON DR APT 104",
"city": "ROLLING MEADOWS",
"state": "IL",
"postal_code": "600083367",
"telephone_number": "414-510-7981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 MCHENRY RD",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600891705",
"telephone_number": "847-532-3492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBLENTZ",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-05",
"last_updated": "2022-09-05",
"certification_date": "2022-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.014826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.