Active NPI
Kelly Marie Christiansen, OTRL
- Occupational Therapist
- St Charles, IL
National Provider Identifier
1780741579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056007899
- Practice address
- 40W310 Lafox Rd
Suite 1a
St Charles, IL 60175-6588 - Phone
- (630) 444-0078
- NPI assigned
- Jan 2, 2007
- Last updated
- Jan 29, 2009
- 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 | 056007899 | IL | Primary |
Addresses
Primary practice location
40W310 Lafox Rd
Suite 1a
St Charles, IL 60175-6588
Mailing address
1025 Crane PT
Elgin, IL 60124-7885
Phone (630) 452-2422
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 |
|---|---|---|---|
| 056007899 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1780741579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 CRANE PT",
"city": "ELGIN",
"state": "IL",
"postal_code": "601247885",
"telephone_number": "630-452-2422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40W310 LAFOX RD",
"address_2": "SUITE 1A",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601756588",
"telephone_number": "630-444-0078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIANSEN",
"first_name": "KELLY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056007899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
- Chiro One Wellness Center of St. Charles LLC
- Chiropractic and Physical Rehabilitation Centers of Illinois
- Kaitlyn Chlapecka
- Danielle Marie Chobak, M.A. CFY-SLP
- Brad Christensen, D.C.
- Ci Psych, PLLC
- Bryan R. Cichon, DDS
- Zbigniew M Ciechanowski, M.D.
- Jerry Ciffone, MSW, LCSW
- City of St Charlesq (Tri City Ambulance)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.