Active NPI
Nita Mohanan, OTR/L
- Occupational Therapist
- Aurora, IL
National Provider Identifier
1659828259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.011316
- Practice address
- 3965 75TH St
Suite 104
Aurora, IL 60504-7925 - Phone
- (630) 236-7000
- NPI assigned
- Sep 1, 2016
- 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 | 056.011316 | IL | Primary |
Addresses
Primary practice location
3965 75TH St
Suite 104
Aurora, IL 60504-7925
Mailing address
1967 Clarendon LN
Aurora, IL 60504-4861
Phone (847) 997-9965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056011316 | Other | IL | LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.011316 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1659828259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1967 CLARENDON LN",
"city": "AURORA",
"state": "IL",
"postal_code": "605044861",
"telephone_number": "847-997-9965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3965 75TH ST",
"address_2": "SUITE 104",
"city": "AURORA",
"state": "IL",
"postal_code": "605047925",
"telephone_number": "630-236-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHANAN",
"first_name": "NITA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.011316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "056011316",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.