Individual provider Active NPI

Abby Nicole Gentile

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1447980495
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.015463 Issued in IL
Practice address
1409 W Carroll Ave
Chicago, IL 60607-1105
Phone
(312) 733-0883
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 14770 NC
Occupational Therapist 225X00000X 056.015463 IL Primary

Addresses

Primary practice location

1409 W Carroll Ave
Chicago, IL 60607-1105

Mailing address

1409 W Carroll Ave
Chicago, IL 60607-1105
Phone (312) 733-0883

Other practice location 1

1502 W Nc Highway 54 Ste 103
Durham, NC 27707-5572
Phone (919) 361-1090

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

LicenseStateTypeSpecialty
056.015463ILMDOccupational Therapist
14770NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyas Landing, Inc. PastSince Jun 4, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1447980495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 W CARROLL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071105",
            "telephone_number": "312-733-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 W CARROLL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071105",
            "telephone_number": "312-733-0883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1502 W Nc Highway 54 Ste 103",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277075572",
            "country_code": "US",
            "telephone_number": "919-361-1090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "ABBY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14770",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.015463",
            "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 Jun 1, 2023; 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.