Active NPI
Kimberely M Mraz, OTR
- Occupational Therapist
- Frankfort, IL
National Provider Identifier
1497077077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056001368
- Practice address
- 10257 W Lincoln Hwy
Frankfort, IL 60423-1279 - Phone
- (815) 469-1500
- NPI assigned
- Feb 23, 2010
- 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 | 056001368 | IL | Primary |
Addresses
Primary practice location
10257 W Lincoln Hwy
Frankfort, IL 60423-1279
Mailing address
5816 E 9000N Rd
Manteno, IL 60950-3506
Phone (815) 468-3298
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 |
|---|---|---|---|
| 056001368 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266883200000",
"number": "1497077077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5816 E 9000N RD",
"city": "MANTENO",
"state": "IL",
"postal_code": "609503506",
"telephone_number": "815-468-3298",
"fax_number": "815-468-3298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10257 W LINCOLN HWY",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604231279",
"telephone_number": "815-469-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MRAZ",
"first_name": "KIMBERELY",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2010-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056001368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frankfort, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.