Cecelia J Dietzen

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056008482 Issued in IL

Practice address

830 S Addison Ave
Villa Park, IL 60181-2877

Phone

(630) 282-2025

Fax

(630) 620-1148

NPI assigned

Oct 16, 2008

Last updated

Oct 16, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1568614048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 WILLOW AVE",
            "address_2": "2E",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482500",
            "telephone_number": "630-282-2025",
            "fax_number": "630-620-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S ADDISON AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812877",
            "telephone_number": "630-282-2025",
            "fax_number": "630-620-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZEN",
        "first_name": "CECELIA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056008482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Villa Park, IL
• Providers in Villa Park, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.