Doha Qatrina Pascual Bergantinos, OTR/L,
Individual provider Active NPI Occupational Therapist · Niles, IL
NPI 1528396249 · NPPES record last updated Jan 15, 2022
Key facts
- NPI
- 1528396249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056008870 (IL)
- Practice address
- 8613 N Milwaukee Ave Apt 1W
Niles, IL 60714-1965 - Phone
- (352) 200-9811
- NPI assigned
- Nov 19, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056008870 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medpro | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056008870 | IL | Yes |
Addresses
Primary practice location
8613 N Milwaukee Ave Apt 1W
Niles, IL 60714-1965
Mailing address
8613 N Milwaukee Ave Apt 1W
Niles, IL 60714-1965
Phone (352) 200-9811
Other providers in Niles, IL
- Laura L Baron
- Paul S Bartkowski
- Stephanie Denise Bell
- Svetlana Belovol
- Kathie Benson
- Raymond J Bielinski
- Antonio E Bifero
- Grzegorz Bigaj
- Muhammad Shoaib Bilal
- Bio-Medical Applications of Illinois, Inc.
All providers in Niles, IL · Occupational Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.