Active NPI
Karina Briseno
- Occupational Therapy Assistant
- Chicago, IL
National Provider Identifier
1740826585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 057.005311
- Practice address
- 1500 N Clybourn Ave Unit C105
Chicago, IL 60610-2295 - Phone
- (312) 242-1665
- NPI assigned
- Nov 26, 2019
- Last updated
- Nov 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057.005311 | IL | Primary |
Addresses
Primary practice location
1500 N Clybourn Ave Unit C105
Chicago, IL 60610-2295
Mailing address
241 W 29TH St
South Chicago Heights, IL 60411-4757
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
| License | State | Type | Specialty |
|---|---|---|---|
| 057.005311 | IL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lumiere Children's Therapy, LLC | Current | Accepting new patients |
Locations
1500 N Clybourn Ave
Unit C105
Chicago, IL 60610
Phone (312) 202-4216
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Developmental - Behavioral Pediatrics Physician
- Chicago, IL
- NPI 1497054050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1740826585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 W 29TH ST",
"city": "SOUTH CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604114757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 N CLYBOURN AVE UNIT C105",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606102295",
"telephone_number": "312-242-1665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISENO",
"first_name": "KARINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-26",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.005311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.