Individual provider Active NPI

Adam Vasconcelles, OTR/L

  • Occupational Therapist
  • Evanston, IL
National Provider Identifier
1538044862
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.016397 Issued in IL
Practice address
1611 Chicago Ave
Evanston, IL 60201-6019
Phone
(877) 343-0506
NPI assigned
Aug 6, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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 056.016397 IL Primary

Addresses

Primary practice location

1611 Chicago Ave
Evanston, IL 60201-6019

Mailing address

4108 Southwoods Rd
Springfield, IL 62711-6071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251017002497 IL Practitioner - Occupational Therapist in Private Practice 0749777100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

1611 Chicago Ave
Evanston, IL 60201-6019
Phone (224) 394-5810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.016397ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Occupational Therapist CurrentSince Sep 9, 2025 Accepting new patients

Locations

28100 Torch Pkwy
Ste 600
Warrenville, IL 60555
Phone (630) 250-4576

7125 Janes Ave
Ste 300
Woodridge, IL 60517
Phone (630) 413-5817

Organizations & group practices 1

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": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1538044862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 SOUTHWOODS RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602016019",
            "telephone_number": "877-343-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASCONCELLES",
        "first_name": "ADAM",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.016397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.