NPIMap

Organization Active NPI

Motorvation Pediatric Services

  • Pediatric Occupational Therapist
  • Alsip, IL
National Provider Identifier
1609439702
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
MOTORVATION PEDIATRIC SERVICES
Practice address
12615 S Alpine Dr Apt 6
Alsip, IL 60803-3319
Phone
(773) 879-0436
NPI assigned
Apr 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Mrs. Latesha M Campbell, MOT OTR/L
Title
Owner
Phone
(773) 879-0436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

12615 S Alpine Dr Apt 6
Alsip, IL 60803-3319

Mailing address

12615 S Alpine Dr Apt 6
Alsip, IL 60803-3319
Phone (773) 879-0436

Other identifiers 1

IdentifierTypeStateIssuer
1578998167MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1609439702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 S ALPINE DR APT 6",
            "city": "ALSIP",
            "state": "IL",
            "postal_code": "608033319",
            "telephone_number": "773-879-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 S ALPINE DR APT 6",
            "city": "ALSIP",
            "state": "IL",
            "postal_code": "608033319",
            "telephone_number": "773-879-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTORVATION PEDIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "LATESHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-879-0436",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MOT OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578998167",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alsip, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.