Individual provider Active NPI

Sarah Dziewulski, COTA/L

  • Occupational Therapy Assistant
  • Lake in the Hills, IL
National Provider Identifier
1689391419
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057005740 Issued in IL
Practice address
1301 Pyott Rd Ste 109
Lake in the Hills, IL 60156-9796
Phone
(847) 542-6555
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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 057005740 IL Primary

Addresses

Primary practice location

1301 Pyott Rd Ste 109
Lake in the Hills, IL 60156-9796

Mailing address

530 S Annandale Dr
Lake in the Hills, IL 60156-6273
Phone (847) 542-6555

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
057005740ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1689391419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S ANNANDALE DR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566273",
            "telephone_number": "847-542-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PYOTT RD STE 109",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601569796",
            "telephone_number": "847-542-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEWULSKI",
        "first_name": "SARAH",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057005740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.