Individual provider Active NPI

Christina Thom, OTRL

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1871149450
Registry record updated Aug 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201008754 Issued in MI
Practice address
3450 N Lake Shore Dr Apt 3506
Chicago, IL 60657-2864
Phone
(734) 634-0564
NPI assigned
Aug 10, 2019
Last updated
Aug 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201008754 MI Primary

Addresses

Primary practice location

3450 N Lake Shore Dr Apt 3506
Chicago, IL 60657-2864

Mailing address

3450 N Lake Shore Dr Apt 3506
Chicago, IL 60657-2864
Phone (734) 634-0564

Other practice location 1

42310 Waterfall Rd
Northville, MI 48168-2247
Phone (734) 634-0564

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201008754MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Durable Medical Equipment of Alaska LLC CurrentSince Oct 16, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565395200000",
    "number": "1871149450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N LAKE SHORE DR APT 3506",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572864",
            "telephone_number": "734-634-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 N LAKE SHORE DR APT 3506",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572864",
            "telephone_number": "734-634-0564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42310 Waterfall Rd",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481682247",
            "country_code": "US",
            "telephone_number": "734-634-0564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOM",
        "first_name": "CHRISTINA",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-10",
        "last_updated": "2019-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008754",
            "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 Aug 10, 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.