Individual provider Active NPI

Nicole Marie Remblos Molina, OTD, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1457027948
Registry record updated May 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.014352 Issued in IL
Practice address
1962 N Bissell St Ste 1
Chicago, IL 60614-0558
Phone
(312) 598-9991
NPI assigned
Aug 17, 2021
Last updated
May 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.014352 IL Primary

Addresses

Primary practice location

1962 N Bissell St Ste 1
Chicago, IL 60614-0558

Mailing address

1962 N Bissell St Ste 1
Chicago, IL 60614-0558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230515001327 IL Practitioner - Occupational Therapist in Private Practice 6709242944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beyond Physical Therapy PLLCGroup PAC ID 4284096553, 4 clinicians

Practice addresses (Care Compare)

10730 W 143Rd St
Suite 31
Orland Park, IL 60462-1975
Phone (708) 966-2945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.014352ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Physical Therapy, PLLC CurrentSince Nov 1, 2024 Accepting new patients
Bricolage Wellness, LLC PastSince Aug 1, 2022 Accepting new patients

Locations

10730 W 143rd St
Ste 31
Orland Park, IL 60462
Phone (708) 966-2945

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685145600000",
    "number": "1457027948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1962 N BISSELL ST STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606140558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1962 N BISSELL ST STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606140558",
            "telephone_number": "312-598-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMBLOS MOLINA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2023-05-27",
        "certification_date": "2023-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.014352",
            "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 May 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.