Individual provider Active NPI

Holly Prowant, COTA/L

  • Occupational Therapy Assistant
  • Westmont, IL
National Provider Identifier
1689273682
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.005391 Issued in IL
Practice address
750 Pasquinelli Dr Ste 204
Westmont, IL 60559-1291
Phone
(630) 560-0136
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.005391 IL Primary

Addresses

Primary practice location

750 Pasquinelli Dr Ste 204
Westmont, IL 60559-1291

Mailing address

19 N Staffire Dr
Schaumburg, IL 60194-3857
Phone (630) 415-5044

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
057.005391ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1689273682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N STAFFIRE DR",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601943857",
            "telephone_number": "630-415-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 PASQUINELLI DR STE 204",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591291",
            "telephone_number": "630-560-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROWANT",
        "first_name": "HOLLY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.