Individual provider Active NPI

Allison Mlyniec

  • Occupational Therapist
  • Rockford, IL
National Provider Identifier
1790624302
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056014794 Issued in IL
Practice address
4920 E State St Ste 4
Rockford, IL 61108-2262
Phone
(815) 601-6627
NPI assigned
Mar 27, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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 056014794 IL Primary

Addresses

Primary practice location

4920 E State St Ste 4
Rockford, IL 61108-2262

Mailing address

2005 Wichita Dr
Rockford, IL 61108-6748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260410000219 IL Practitioner - Occupational Therapist in Private Practice 6305311002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Motivate Health IncGroup PAC ID 0042468357, 5 clinicians

Practice addresses (Care Compare)

4920 E State St
Suite 4
Rockford, IL 61108-2262
Phone (815) 637-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056014794ILMDOccupational Therapist

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": "1774569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1790624302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 WICHITA DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 E STATE ST STE 4",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082262",
            "telephone_number": "815-601-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLYNIEC",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-03-27",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056014794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.