Individual provider Active NPI

Itiona M Scott

  • Occupational Therapist
  • Bolingbrook, IL
National Provider Identifier
1760580963
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.007492 Issued in IL
Practice address
2388 River Hills LN
Bolingbrook, IL 60490-4937
Phone
(630) 310-2236
NPI assigned
Sep 20, 2006
Last updated
Jan 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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 056.007492 IL Primary

Addresses

Primary practice location

2388 River Hills LN
Bolingbrook, IL 60490-4937

Mailing address

PO Box 127
Plainfield, IL 60544-0127
Phone (630) 310-2236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060921000369 IL Practitioner - Occupational Therapist in Private Practice 8426053612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9020 S Stony Island Ave
Chicago, IL 60617-3508
Phone (630) 310-2235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.007492ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Holistic Healthcare Services, Inc. Occupational Therapist CurrentSince Mar 1, 2010 Accepting new patients
Covenant Holistic Healthcare Services Inc Occupational Therapist Past Accepting new patients
Covenant Holistic Healthcare Services Inc. Occupational Therapist Past Accepting new patients

Locations

10241 S Commercial Ave
Chicago, IL 60617
Phone (630) 310-2235

1436 W Randolph St
Chicago, IL 60607
Phone (630) 310-2235

9020 S Stony Island Ave
Chicago, IL 60617
Phone (630) 310-2235

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1760580963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605440127",
            "telephone_number": "630-310-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 RIVER HILLS LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604904937",
            "telephone_number": "630-310-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ITIONA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.007492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.