Individual provider Active NPI

Safa Fatima Muntajibuddin, M.S., OTR

  • Pediatric Occupational Therapist
  • Glenview, IL
National Provider Identifier
1457712754
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
1308 Waukegan Rd
Suite 103
Glenview, IL 60025-3070
Phone
(847) 486-4140
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X IL Primary

Addresses

Primary practice location

1308 Waukegan Rd
Suite 103
Glenview, IL 60025-3070

Mailing address

950 Lee St
Suite 210
Des Plaines, IL 60016-6532
Phone (877) 486-4140

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Pediatric Therapy Pediatrics Past Accepting new patients
Pediatric Therapy Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1457712754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE ST",
            "address_2": "SUITE 210",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166532",
            "telephone_number": "877-486-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 WAUKEGAN RD",
            "address_2": "SUITE 103",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253070",
            "telephone_number": "847-486-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNTAJIBUDDIN",
        "first_name": "SAFA",
        "middle_name": "FATIMA",
        "credential": "M.S., OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.