Active NPI
Nicole Grace Deleonardis
- Occupational Therapist
- St Charles, IL
National Provider Identifier
1487120960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.012720
- Practice address
- 3815 E Main St Ste B
Saint Charles, IL 60174-2488 - Phone
- (630) 584-7530
- NPI assigned
- Oct 22, 2018
- Last updated
- Oct 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.012720 | IL | Primary |
Addresses
Primary practice location
3815 E Main St Ste B
Saint Charles, IL 60174-2488
Mailing address
2441 S 10TH Ave
North Riverside, IL 60546-1120
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.012720 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540166400000",
"number": "1487120960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2441 S 10TH AVE",
"city": "NORTH RIVERSIDE",
"state": "IL",
"postal_code": "605461120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3815 E MAIN ST STE B",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601742488",
"telephone_number": "630-584-7530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELEONARDIS",
"first_name": "NICOLE",
"middle_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-22",
"last_updated": "2018-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.012720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
- Nicole Renee Decker, BCBA
- Samantha Nicole Dedic
- Dedicated to Growth Therapy, PLLC
- Anariella Cristina Defrancesco, PHARMD
- John Deku, LCPC, NCC
- Delnor Community Hospital (Delnor Community Hospital Home Health Care Services)
- Delnor Home Medical Equipment
- Elijah Paul Delosreyes
- Joan Demers Bittner, RBT
- Pamela Marie Denhof, ATC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.