Individual provider Active NPI

Dzenan Nezirevic, OT

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1497403786
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.014319 Issued in IL
Practice address
4412 S Pulaski Rd
Chicago, IL 60632-4011
Phone
(773) 847-3123
Fax
(773) 847-3778
NPI assigned
Mar 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.014319 IL Primary

Addresses

Primary practice location

4412 S Pulaski Rd
Chicago, IL 60632-4011

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other practice location 1

1300 Busch Pkwy
Buffalo Grove, IL 60089-4505
Phone (847) 378-4970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220427002126 IL Practitioner - Occupational Therapist in Private Practice 8325435001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reinvent Health Inc.Group PAC ID 2264964477, 38 clinicians

Practice addresses (Care Compare)

Chicago, IL 60622
Phone (405) 821-6648

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.014319ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cadence Physical Therapy Co Occupational Therapist CurrentSince Apr 1, 2022 Accepting new patients
Athletico LTD CurrentSince Jul 15, 2022 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Jul 15, 2022 Accepting new patients
Reinvent Health Inc CurrentSince Nov 12, 2025 Accepting new patients

Locations

1300 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 378-4970

4412 S Pulaski Rd
Chicago, IL 60632
Phone (773) 847-3123

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1497403786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324011",
            "telephone_number": "773-847-3123",
            "fax_number": "773-847-3778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Busch Pkwy",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600894505",
            "country_code": "US",
            "telephone_number": "847-378-4970",
            "fax_number": "847-728-6125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEZIREVIC",
        "first_name": "DZENAN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.014319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.