Active NPI
Laura Leon
- Occupational Therapy Assistant
- Berwyn, IL
National Provider Identifier
1497938617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057004576
- Practice address
- 1313 Ridgeland Ave
Apt 2
Berwyn, IL 60402-4541 - Phone
- (773) 844-9147
- NPI assigned
- Dec 11, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interpreter | 171R00000X | |||
| Occupational Therapy Assistant | 224Z00000X | 057004576 | IL | Primary |
Addresses
Primary practice location
1313 Ridgeland Ave
Apt 2
Berwyn, IL 60402-4541
Mailing address
1313 Ridgeland Ave
Apt 2
Berwyn, IL 60402-4541
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 |
|---|---|---|---|
| 057004576 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472256000000",
"number": "1497938617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1313 RIDGELAND AVE",
"address_2": "APT 2",
"city": "BERWYN",
"state": "IL",
"postal_code": "604024541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 RIDGELAND AVE",
"address_2": "APT 2",
"city": "BERWYN",
"state": "IL",
"postal_code": "604024541",
"telephone_number": "773-844-9147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-11",
"last_updated": "2016-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "171R00000X",
"taxonomy_group": "",
"desc": "Interpreter",
"state": null,
"license": null,
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057004576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.