NPIMap

Organization Active NPI

Kidnectivity

  • Pediatric Occupational Therapist
  • Northbrook, IL
National Provider Identifier
1710375969
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056005840 Issued in IL
Legal business name
KIDNECTIVITY
Practice address
600 Waukegan Rd Ste 132
Northbrook, IL 60062-1249
Phone
(847) 748-8733
Fax
(847) 739-7164
NPI assigned
Dec 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Jenifer Bates
Title
Business Director
Phone
(847) 239-2177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 056005840 IL Primary

Addresses

Primary practice location

600 Waukegan Rd Ste 132
Northbrook, IL 60062-1249

Mailing address

600 Waukegan Rd Ste 132
Northbrook, IL 60062-1249
Phone (847) 748-8733

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1710375969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WAUKEGAN RD STE 132",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621249",
            "telephone_number": "847-748-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WAUKEGAN RD STE 132",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621249",
            "telephone_number": "847-748-8733",
            "fax_number": "847-739-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNECTIVITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2025-09-11",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "JENIFER",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "847-239-2177"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056005840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.