Active NPI
Michelle Miklasz, M.S, OTR/L
- Occupational Therapist
- Homer Glen, IL
National Provider Identifier
1760837645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056011504
- Practice address
- 14222 S Bell Rd
Homer Glen, IL 60491-8122 - Phone
- (815) 469-1500
- Fax
- (779) 216-3069
- NPI assigned
- Apr 28, 2016
- 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 Therapist | 225X00000X | 056011504 | IL | Primary |
Addresses
Primary practice location
14222 S Bell Rd
Homer Glen, IL 60491-8122
Mailing address
14222 S Bell Rd
Homer Glen, IL 60491-8122
Phone (815) 469-1500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056011504 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westside Childrens Therapy | Occupational Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1760837645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14222 S BELL RD",
"city": "HOMER GLEN",
"state": "IL",
"postal_code": "604918122",
"telephone_number": "815-469-1500",
"fax_number": "779-216-3069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14222 S BELL RD",
"city": "HOMER GLEN",
"state": "IL",
"postal_code": "604918122",
"telephone_number": "815-469-1500",
"fax_number": "779-216-3069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKLASZ",
"first_name": "MICHELLE",
"credential": "M.S, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-28",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056011504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homer Glen, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.