Individual provider Active NPI

Kristen Grider, OT

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1770761512
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056-007991 Issued in IL
Practice address
4080 N Milwaukee Ave
Chicago, IL 60641-1831
Phone
(773) 545-1153
Fax
(773) 545-1588
NPI assigned
Feb 4, 2008
Last updated
Oct 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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 056-007991 IL Primary

Addresses

Primary practice location

4080 N Milwaukee Ave
Chicago, IL 60641-1831

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100430000156 IL Practitioner - Occupational Therapist in Private Practice 8921135591 Reassigns benefits to 3 organizations
I20161017000668 IN Practitioner - Occupational Therapist in Private Practice 8921135591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1611 W Harrison St
Suite 107
Chicago, IL 60612-4861
Phone (877) 632-6637

9200 Calumet Ave
Suite N500
Munster, IN 46321-2849
Phone (877) 632-6637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
056-007991ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Mar 1, 2013 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Jan 1, 2010 Accepting new patients
Orthomidwest, PLLC Occupational Therapist CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Jan 1, 2010 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Mar 1, 2013 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Ste 107
Chicago, IL 60612
Phone (312) 432-2513

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

4080 N Milwaukee Ave
Chicago, IL 60641
Phone (773) 545-1153

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

2011 York Rd
Ste 1500
Oak Brook, IL 60523
Phone (708) 492-5630

2011 York Rd
Ste 3000
Oak Brook, IL 60523
Phone (414) 732-2577

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

9200 Calumet Ave
#300
Munster, IN 46321

9200 Calumet Ave
Ste N500
Munster, IN 46321
Phone (219) 513-9955

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

Organizations & group practices 6

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": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1770761512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411831",
            "telephone_number": "773-545-1153",
            "fax_number": "773-545-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "KRISTEN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-007991",
            "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 Oct 6, 2016; 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.