Individual provider Active NPI

Thomas J Costin, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1932079498
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056017065 Issued in IL
Practice address
11053 S Millard Ave
Chicago, IL 60655-3327
Phone
(773) 253-9856
NPI assigned
Nov 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 056017065 IL Primary

Addresses

Primary practice location

11053 S Millard Ave
Chicago, IL 60655-3327

Mailing address

2603 W 99TH St
Chicago, IL 60655-1667
Phone (310) 904-2420

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
OT28364CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy West, Inc Occupational Therapist CurrentSince Dec 21, 2025 Accepting new patients

Locations

11460 W Washington Blvd
Los Angeles, CA 90066
Phone (310) 337-7115

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": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1932079498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 W 99TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606551667",
            "telephone_number": "310-904-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11053 S MILLARD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606553327",
            "telephone_number": "773-253-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTIN",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-10",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056017065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.