Individual provider Active NPI

Holly Velazquez, DT, CCLS

  • Developmental Therapist
  • Chicago, IL
National Provider Identifier
1821438979
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
310 N Loomis St
Chicago, IL 60607-1147
Phone
(312) 243-8487
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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 IL Primary

Addresses

Primary practice location

310 N Loomis St
Chicago, IL 60607-1147

Mailing address

310 N Loomis St
Chicago, IL 60607-1147
Phone (312) 243-8487

Other practice location 1

1921 W Irving Park Rd
Chicago, IL 60613-2407
Phone (773) 687-9442

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services IL LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services IL LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808000782 IL Practitioner - Occupational Therapist in Private Practice 4183085178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000

7 Clyde Rd
Somerset, NJ 08873-5049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Il LLC CurrentSince Jul 22, 2023 Accepting new patients
Blue Bird Day LLC Developmental Therapist Past Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1821438979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-243-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-243-8487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1921 W Irving Park Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606132407",
            "country_code": "US",
            "telephone_number": "773-687-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "HOLLY",
        "credential": "DT, CCLS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services IL LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "407 W 63rd St",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605592910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services IL LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "6840 N Sacramento Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606452740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 3, 2025; 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.