Individual provider Active NPI

Adam A Szudarski, OT

  • Occupational Therapist
  • Des Plaines, IL
National Provider Identifier
1699023507
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-009827 Issued in IL
Practice address
1479 Lee St
Des Plaines, IL 60018-1516
Phone
(847) 299-7470
Fax
(847) 299-7560
NPI assigned
Aug 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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 056-009827 IL Primary

Addresses

Primary practice location

1479 Lee St
Des Plaines, IL 60018-1516

Mailing address

1479 Lee St
Des Plaines, IL 60018-1516
Phone (847) 299-7470

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
056-009827ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1699023507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 LEE ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600181516",
            "telephone_number": "847-299-7470",
            "fax_number": "847-299-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 LEE ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600181516",
            "telephone_number": "847-299-7470",
            "fax_number": "847-299-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZUDARSKI",
        "first_name": "ADAM",
        "middle_name": "A",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-009827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.