Individual provider Active NPI

Nicole Kreller, MS DT

  • Developmental Therapist
  • Chicago, IL
National Provider Identifier
1790952927
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
1323 N Artesian Ave Apt 3F
Chicago, IL 60622-2954
Phone
(773) 615-3202
NPI assigned
May 16, 2008
Last updated
May 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X NU Primary

Addresses

Primary practice location

1323 N Artesian Ave Apt 3F
Chicago, IL 60622-2954

Mailing address

1323 N Artesian Ave Apt 3F
Chicago, IL 60622-2954

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1790952927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 N ARTESIAN AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 N ARTESIAN AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222954",
            "telephone_number": "773-615-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRELLER",
        "first_name": "NICOLE",
        "credential": "MS DT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "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 May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.