Individual provider Active NPI

Mattea Bulthuis

  • Neurorehabilitation Occupational Therapist
  • Glenview, IL
National Provider Identifier
1922739325
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
Practice address
2180 Pfingsten Rd
Glenview, IL 60026-1339
Phone
(847) 503-4000
NPI assigned
Jun 17, 2022
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X NU Primary

Addresses

Primary practice location

2180 Pfingsten Rd
Glenview, IL 60026-1339

Mailing address

1611 N Fernandez Ave
Arlington Heights, IL 60004-3709

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": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1922739325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 N FERNANDEZ AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600043709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 PFINGSTEN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261339",
            "telephone_number": "847-503-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULTHUIS",
        "first_name": "MATTEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.