Individual provider Active NPI

Alyssa S Moravec, OTR/L

  • Occupational Therapist
  • Manteno, IL
National Provider Identifier
1457915506
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056012982 Issued in IL
Practice address
1 Veterans Dr
Manteno, IL 60950-9466
Phone
(815) 468-6581
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
056012982ILMDOccupational Therapist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056012982 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

1 Veterans Dr
Manteno, IL 60950-9466

Mailing address

16642 Charnswood CT
Tinley Park, IL 60477-6800
Phone (708) 699-5394

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 24, 2019.

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1457915506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16642 CHARNSWOOD CT",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776800",
            "telephone_number": "708-699-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "609509466",
            "telephone_number": "815-468-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAVEC",
        "first_name": "ALYSSA",
        "middle_name": "S",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteno, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.