Individual provider Active NPI

Claire Kaczanowski, OTR/L

  • Occupational Therapist
  • Blue Island, IL
National Provider Identifier
1689562589
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.016498 Issued in IL
Practice address
12757 Western Ave
Blue Island, IL 60406-2155
Phone
(708) 293-8510
NPI assigned
Jun 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 056.016498 IL Primary

Addresses

Primary practice location

12757 Western Ave
Blue Island, IL 60406-2155

Mailing address

3222 W Beach Ave Apt GB
Chicago, IL 60651-2471
Phone (616) 550-3677

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
056.016498ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1689562589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 W BEACH AVE APT GB",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512471",
            "telephone_number": "616-550-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12757 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062155",
            "telephone_number": "708-293-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZANOWSKI",
        "first_name": "CLAIRE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.016498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.