Active NPI
Siegfred T. Celis
- Occupational Therapy Assistant
- Champaign, IL
National Provider Identifier
1487129730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.003304
- Practice address
- 1820 Oak Park Drive
Champaign, IL 61822 - Phone
- (217) 721-4420
- NPI assigned
- Oct 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 057.003304 | IL | Primary |
Addresses
Primary practice location
1820 Oak Park Drive
Champaign, IL 61822
Mailing address
1820 Oak Park Dr
Champaign, IL 61822-5275
Phone (217) 721-4420
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 |
|---|---|---|---|
| 057.003304 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539302400000",
"number": "1487129730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 OAK PARK DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618225275",
"telephone_number": "217-721-4420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 OAK PARK DRIVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61822",
"telephone_number": "217-721-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CELIS",
"first_name": "SIEGFRED",
"middle_name": "T.",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-12",
"last_updated": "2018-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.003304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
- Kevin Nathaniel Causley, M.S.W.
- Amanda Cavazos, PMHNP-BC
- Laura Cayce, D.C.
- CCM Champaign County Mobility LL
- Cindy San Esteban Cecilio, RPT
- Center for Health Renewal and Longevity LLC
- Central Illinois Diagnostic Imaging Center, LLC
- Central Illinois Oral and Maxillofacial Surgery, PC (Champaign Oral Surgery Center)
- Central Illinois Oral and Maxiofacial Surgery, PC (Dr. Firas Ali, DMD)
- Central State Chiropractic & Rehabilitation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.