Active NPI
Rose Diaz, OTR
- Occupational Therapist
- Orland Park, IL
National Provider Identifier
1487921904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056009217
- Practice address
- 11411 W 183Rd St
Suite B
Orland Park, IL 60467-9450 - Phone
- (708) 478-1820
- Fax
- (708) 478-3316
- NPI assigned
- Nov 29, 2011
- 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 | 056009217 | IL | Primary |
Addresses
Primary practice location
11411 W 183Rd St
Suite B
Orland Park, IL 60467-9450
Mailing address
11411 W 183Rd St
Suite B
Orland Park, IL 60467-9450
Phone (708) 478-1820
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 |
|---|---|---|---|
| 056009217 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bautz Developmental Intervention Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Orland Park, IL
- NPI 1376530055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1487921904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11411 W 183RD ST",
"address_2": "SUITE B",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604679450",
"telephone_number": "708-478-1820",
"fax_number": "708-478-3316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11411 W 183RD ST",
"address_2": "SUITE B",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604679450",
"telephone_number": "708-478-1820",
"fax_number": "708-478-3316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "ROSE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-29",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056009217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.