Individual provider Active NPI

Kerry Fiala, OT

  • Occupational Therapist
  • Morton Grove, IL
National Provider Identifier
1922054899
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
9000 Waukegan Rd
Suite 100
Morton Grove, IL 60053-2111
Phone
(847) 779-6050
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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 IL Primary

Addresses

Primary practice location

9000 Waukegan Rd
Suite 100
Morton Grove, IL 60053-2111

Mailing address

8930 Waukegan Rd
Suite 200 - Attn: Raquel Leon
Morton Grove, IL 60053-2126
Phone (847) 324-3976

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
056-006144ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1922054899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 WAUKEGAN RD",
            "address_2": "SUITE 200 - ATTN: RAQUEL LEON",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532126",
            "telephone_number": "847-324-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 WAUKEGAN RD",
            "address_2": "SUITE 100",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532111",
            "telephone_number": "847-779-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALA",
        "first_name": "KERRY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.