Active NPI
Yesenia Rivera, OTR L
- Pediatric Rehabilitation Medicine Physician
- Chicago, IL
National Provider Identifier
1831246560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Rehabilitation Medicine Physician
- License
- 056.007511
- Practice address
- 1129 N Homan Ave
Chicago, IL 60651-4008 - Phone
- (773) 351-2902
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Rehabilitation Medicine Physician | 2081P0010X | 056.007511 | IL | Primary |
Addresses
Primary practice location
1129 N Homan Ave
Chicago, IL 60651-4008
Mailing address
1129 N Homan Ave
Chicago, IL 60651-4008
Phone (773) 351-2902
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.007511 | IL | MD | Pediatric Rehabilitation Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327363200000",
"number": "1831246560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1129 N HOMAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606514008",
"telephone_number": "773-351-2902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 N HOMAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606514008",
"telephone_number": "773-351-2902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "YESENIA",
"credential": "OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2012-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "2081P0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
"state": "IL",
"license": "056.007511",
"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 Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.