Individual provider Active NPI

Kasey Kotsiris, OTR/L

  • Occupational Therapist
  • Park Ridge, IL
National Provider Identifier
1679107726
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056013435 Issued in IL
Practice address
422 N Northwest Hwy Ste 210
Park Ridge, IL 60068-3273
Phone
(847) 699-9757
Fax
(847) 696-3626
NPI assigned
Feb 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056013435 IL Primary

Addresses

Primary practice location

422 N Northwest Hwy Ste 210
Park Ridge, IL 60068-3273

Mailing address

422 N Northwest Hwy Ste 210
Park Ridge, IL 60068-3273
Phone (847) 699-9757

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

LicenseStateTypeSpecialty
056013435ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Assential Therapies Inc PastSince Mar 1, 2020 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1679107726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 N NORTHWEST HWY STE 210",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683273",
            "telephone_number": "847-699-9757",
            "fax_number": "847-696-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 N NORTHWEST HWY STE 210",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683273",
            "telephone_number": "847-699-9757",
            "fax_number": "847-696-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTSIRIS",
        "first_name": "KASEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056013435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.