Individual provider Active NPI

Mari Guin Riesen, MS, OTR/L

  • Occupational Therapist
  • Glenview, IL
National Provider Identifier
1740455724
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056001698 Issued in IL
Practice address
3703 W Lake Ave
Suite 200
Glenview, IL 60026-5823
Phone
(847) 998-1188
NPI assigned
Apr 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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 056001698 IL Primary

Addresses

Primary practice location

3703 W Lake Ave
Suite 200
Glenview, IL 60026-5823

Mailing address

4035 N Monticello Ave
Chicago, IL 60618-2117
Phone (773) 588-3066

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
056001698ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1740455724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 N MONTICELLO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182117",
            "telephone_number": "773-588-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 W LAKE AVE",
            "address_2": "SUITE 200",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265823",
            "telephone_number": "847-998-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESEN",
        "first_name": "MARI",
        "middle_name": "GUIN",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056001698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.