Individual provider Active NPI

Daniella Nitzoy, MOTR/L

  • Pediatric Occupational Therapist
  • Oak Park, IL
National Provider Identifier
1902365414
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056012941 Issued in IL
Practice address
1144 Lake St Ste 200B
Oak Park, IL 60301-1043
Phone
(639) 907-9165
NPI assigned
Mar 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 056012941 IL Primary

Addresses

Primary practice location

1144 Lake St Ste 200B
Oak Park, IL 60301-1043

Mailing address

729 Hayes Ave
Oak Park, IL 60302-1705
Phone (773) 474-1546

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

LicenseStateTypeSpecialty
056012941ILMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidsconnect Pediatric Therapy, PLLC Pediatrics CurrentSince May 28, 2023 Accepting new patients

Locations

1144 Lake St
Ste 200B
Oak Park, IL 60301
Phone (639) 907-9165

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1902365414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 HAYES AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021705",
            "telephone_number": "773-474-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 LAKE ST STE 200B",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011043",
            "telephone_number": "639-907-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITZOY",
        "first_name": "DANIELLA",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056012941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.