Individual provider Active NPI

Evangelia Kyriakos Cucuras, OTD, OTR/L

  • Pediatric Occupational Therapist
  • Downers Grove, IL
National Provider Identifier
1467117887
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056.014547 Issued in IL
Practice address
1101 31St St Ste 110
Downers Grove, IL 60515-5562
Phone
(630) 929-0122
NPI assigned
Nov 1, 2021
Last updated
Nov 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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 056.014547 IL Primary

Addresses

Primary practice location

1101 31St St Ste 110
Downers Grove, IL 60515-5562

Mailing address

4535 Clearwater LN
Naperville, IL 60564-6135
Phone (630) 770-7347

Other identifiers 1

IdentifierTypeStateIssuer
QME921584518OtherILBLUECROSS BLUESHIELD OF ILLINOIS

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
056.014547ILMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediaprogress, Inc. Pediatrics CurrentSince Nov 9, 2021 Accepting new patients

Locations

1101 31st St
Ste 110
Downers Grove, IL 60515
Phone (630) 929-0122

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, 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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1467117887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 CLEARWATER LN",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605646135",
            "telephone_number": "630-770-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 31ST ST STE 110",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155562",
            "telephone_number": "630-929-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCURAS",
        "first_name": "EVANGELIA",
        "middle_name": "KYRIAKOS",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056.014547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF ILLINOIS",
            "identifier": "QME921584518",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.