Individual provider Active NPI

Alexis Vittallo, OTR/L

  • Occupational Therapist
  • Skokie, IL
National Provider Identifier
1699506717
Registry record updated Aug 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.015648 Issued in IL
Practice address
8707 Skokie Blvd Ste 402
Skokie, IL 60077-2269
Phone
(847) 877-5210
NPI assigned
Aug 10, 2024
Last updated
Aug 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2024

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 056.015648 IL Primary

Addresses

Primary practice location

8707 Skokie Blvd Ste 402
Skokie, IL 60077-2269

Mailing address

5462 N la Crosse Ave
Chicago, IL 60630-1551
Phone (224) 567-9989

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
056.015648ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1699506717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5462 N LA CROSSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301551",
            "telephone_number": "224-567-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD STE 402",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772269",
            "telephone_number": "847-877-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITTALLO",
        "first_name": "ALEXIS",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.015648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; 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.