Individual provider Active NPI

Michelle Lynn Dietz

  • Developmental Therapist
  • Batavia, IL
National Provider Identifier
1760809131
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
1226 Schiedler Dr
Batavia, IL 60510-8617
Phone
(630) 761-4236
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

1226 Schiedler Dr
Batavia, IL 60510-8617

Mailing address

1226 Schiedler Dr
Batavia, IL 60510-8617
Phone (630) 761-4236

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

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1760809131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 SCHIEDLER DR",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605108617",
            "telephone_number": "630-761-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 SCHIEDLER DR",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605108617",
            "telephone_number": "630-761-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.