Active NPI
Kristen Theresa Burke
- Occupational Therapy Assistant
- La Grange, IL
National Provider Identifier
1508489907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.005370
- Practice address
- 339 9TH Ave
La Grange, IL 60525 - Phone
- (708) 354-4660
- NPI assigned
- May 20, 2020
- 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 Therapy Assistant | 224Z00000X | 057.005370 | IL | Primary |
Addresses
Primary practice location
339 9TH Ave
La Grange, IL 60525
Mailing address
648 N. River Rd.
Ste 100
Naperville, IL 60563
Phone (773) 558-4075
Other names 1
- Kristen Theresa Letten
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 |
|---|---|---|---|
| 057.005370 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1508489907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "648 N. RIVER RD.",
"address_2": "STE 100",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "60563",
"telephone_number": "773-558-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 9TH AVE",
"city": "LA GRANGE",
"state": "IL",
"postal_code": "60525",
"telephone_number": "708-354-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "KRISTEN",
"middle_name": "THERESA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-20",
"last_updated": "2024-03-13",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.005370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "LETTEN",
"middle_name": "THERESA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in La Grange, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.