Active NPI
Victoria Jean Kelly
- Pediatric Occupational Therapist
- Northbrook, IL
National Provider Identifier
1780828152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 056-001319
- Practice address
- 900 Skokie Blvd Ste 218
Northbrook, IL 60062-4043 - Phone
- (847) 964-2003
- Fax
- (847) 964-2005
- NPI assigned
- Apr 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 056-001319 | IL | Primary |
Addresses
Primary practice location
900 Skokie Blvd Ste 218
Northbrook, IL 60062-4043
Mailing address
1141 Lake Cook Rd Ste C
Deerfield, IL 60015-5235
Phone (847) 964-2003
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 |
|---|---|---|---|
| 056-001319 | IL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750982400000",
"number": "1780828152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 LAKE COOK RD STE C",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600155235",
"telephone_number": "847-964-2003",
"fax_number": "847-964-2005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SKOKIE BLVD STE 218",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600624043",
"telephone_number": "847-964-2003",
"fax_number": "847-964-2005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "VICTORIA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-28",
"last_updated": "2025-06-27",
"certification_date": "2025-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056-001319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.