Active NPI
Malgorzata Helena Malesa, OTR/L
- Occupational Therapist
- Woodstock, IL
National Provider Identifier
1558706861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056-005986
- Practice address
- 920 N Seminary Ave
Woodstock, IL 60098-2996 - Phone
- (815) 338-1749
- NPI assigned
- May 1, 2013
- Last updated
- Oct 23, 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 Therapist | 225X00000X | 056-005986 | IL | Primary |
Addresses
Primary practice location
920 N Seminary Ave
Woodstock, IL 60098-2996
Mailing address
20655 Ela Rd
Deer Park, IL 60010-3509
Phone (847) 606-8011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056-005986 | IL | MD | Occupational Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- North Riverside, IL
- NPI 1699094102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603411200000",
"number": "1558706861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20655 ELA RD",
"city": "DEER PARK",
"state": "IL",
"postal_code": "600103509",
"telephone_number": "847-606-8011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 N SEMINARY AVE",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600982996",
"telephone_number": "815-338-1749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALESA",
"first_name": "MALGORZATA",
"middle_name": "HELENA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-01",
"last_updated": "2020-10-23",
"certification_date": "2020-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056-005986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.