Amanda Valenzuela, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056012899 Issued in IL

Practice address

1651 Richfield Rd
Highland Park, IL 60035-2950

Phone

(224) 765-0094

NPI assigned

Apr 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1821651159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 W JARLATH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 RICHFIELD RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352950",
            "telephone_number": "224-765-0094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Florsheim Dr",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485200",
            "country_code": "US",
            "telephone_number": "866-367-5831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "AMANDA",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.