Marissa Vavra, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.013736 Issued in IL

Practice address

1405 N Hunt Club Rd
Gurnee, IL 60031-2656

Phone

(847) 855-2890

NPI assigned

Oct 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Cortlyn Therapy, PC

  • Physical Therapist
  • Cincinnati, OH
  • NPI 1235725730

  IL

  Medicare reassignment Care Compare group
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441
  NPD (past)

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1821697392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18W108 CLAREMONT DR",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605615702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N HUNT CLUB RD",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312656",
            "telephone_number": "847-855-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVRA",
        "first_name": "MARISSA",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-25",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "endpointDescription": "EMR system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4440 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fehmida M Valiullah, PT
• Romaine A Van Zeyl, LCSW
• Sara J Vanderbloomer, P.T.
• Piper Vanderpool
• Jean Kinney Vargas, MSW, LCSW
• Vcfe of Lake County, Inc
• Verdure Health LLC
• Darlene M Verenski, PT
• Julie Verhagen, PT
• Rajiv Verma, D.O.

• Occupational Therapist in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.