Maximiliano Pena Aguirre, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

56.014654 Issued in IL

Practice address

814 Commerce Dr
Oak Brook, IL 60523-1965

Phone

(630) 590-5571

Fax

(630) 326-7175

NPI assigned

Jan 14, 2022

Last updated

Jan 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• By Your Side, LLC

  dba By Your Side

  • Behavior Analyst
  • Darien, IL
  • NPI 1922233923
  NPD (past)

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1912658584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 CASS AVE",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605615314",
            "telephone_number": "630-590-5571",
            "fax_number": "630-326-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 COMMERCE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231965",
            "telephone_number": "630-590-5571",
            "fax_number": "630-326-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA AGUIRRE",
        "first_name": "MAXIMILIANO",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "56.014654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.

Verify at the official NPI Registry.