Active NPI
Deborah Klyczek, OTR/L
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1659527661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003520
- Practice address
- 13321 S Avenue M
Chicago, IL 60633-1503 - Phone
- (773) 646-3513
- NPI assigned
- Aug 9, 2008
- 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 | 31003520 | IN | Primary |
Addresses
Primary practice location
13321 S Avenue M
Chicago, IL 60633-1503
Mailing address
13784 Empress LN
Dyer, IN 46311-7069
Phone (773) 646-3513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31003520 | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464825600000",
"number": "1659527661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13784 EMPRESS LN",
"city": "DYER",
"state": "IN",
"postal_code": "463117069",
"telephone_number": "773-646-3513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13321 S AVENUE M",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606331503",
"telephone_number": "773-646-3513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLYCZEK",
"first_name": "DEBORAH",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-09",
"last_updated": "2016-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.