Active NPI
Tessa Lee
- Occupational Therapist
- Rockford, IL
National Provider Identifier
1831644749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.010738
- Practice address
- 3422 Lauderdale LN
Rockford, IL 61107 - Phone
- (815) 979-9920
- NPI assigned
- Aug 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.010738 | IL | Primary |
Addresses
Primary practice location
3422 Lauderdale LN
Rockford, IL 61107
Mailing address
3422 Lauderdale LN
Rockford, IL 61107-3536
Phone (815) 979-9920
Other practice location 1
7201 Colosseum Dr Unit 125
Rockford, IL 61107-7204
Phone (815) 979-9920
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 |
|---|---|---|---|
| 056.010738 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530403200000",
"number": "1831644749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3422 LAUDERDALE LN",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611073536",
"telephone_number": "815-979-9920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3422 LAUDERDALE LN",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "61107",
"telephone_number": "815-979-9920"
}
],
"practiceLocations": [
{
"address_1": "7201 Colosseum Dr Unit 125",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "611077204",
"country_code": "US",
"telephone_number": "815-979-9920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "TESSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-20",
"last_updated": "2018-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.010738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.