Kelly Jean Mansouri, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.000587 Issued in IL

Practice address

3703 W Lake Ave
Suite 200
Glenview, IL 60026-5823

Phone

(847) 998-1188

NPI assigned

Apr 23, 2008

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1477728194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 REEF CT",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600907300",
            "telephone_number": "847-459-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 W LAKE AVE",
            "address_2": "SUITE 200",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265823",
            "telephone_number": "847-998-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOURI",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.000587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnes Maria Manish
• Janvi Anoop Manna
• Kathryn Mannion, COTA
• Tina Mansfield
• Laura Kate Manson, MSOT
• Reena Chenna Mantena, PHARM.D.
• Nancy Marie Mantich, MD
• Hayley Elizabeth Mantis, COTA
• Sherry Lynn Manzella
• Katherine E Marchese, APN

• Occupational Therapy Assistant in Glenview, IL
• Providers in Glenview, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.