Active NPI
Sandra Koljovic
- Developmental Therapist
- Park Ridge, IL
National Provider Identifier
1871246629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 1326 N Northwest Hwy
Park Ridge, IL 60068-1352 - Phone
- (773) 899-1510
- NPI assigned
- Feb 1, 2022
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
1326 N Northwest Hwy
Park Ridge, IL 60068-1352
Mailing address
1326 N Northwest Hwy
Park Ridge, IL 60068-1352
Phone (773) 899-1510
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1871246629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1326 N NORTHWEST HWY",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681352",
"telephone_number": "773-899-1510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1326 N NORTHWEST HWY",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681352",
"telephone_number": "773-899-1510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLJOVIC",
"first_name": "SANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-01",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.