Individual provider Active NPI

Ronna Dekoven, OTR L

  • Pediatric Occupational Therapist
  • Skokie, IL
National Provider Identifier
1942325733
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056-000076 Issued in IL
Practice address
8707 Skokie Blvd Ste 402
Skokie, IL 60077-2269
Phone
(847) 877-5210
Fax
(847) 510-0430
NPI assigned
Mar 20, 2007
Last updated
May 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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 056-000076 IL Primary

Addresses

Primary practice location

8707 Skokie Blvd Ste 402
Skokie, IL 60077-2269

Mailing address

1165 Bristol LN
Buffalo Grove, IL 60089-1265
Phone (847) 977-9136

Other practice location 1

2591 Compass Rd
Suite 100
Glenview, IL 60026-8043
Phone (847) 729-6220

Other identifiers 1

IdentifierTypeStateIssuer
1617235OtherILBLUE CROSS BLUE SHIELD

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
056-000076ILMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1942325733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 BRISTOL LN",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891265",
            "telephone_number": "847-977-9136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD STE 402",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772269",
            "telephone_number": "847-877-5210",
            "fax_number": "847-510-0430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2591 Compass Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600268043",
            "country_code": "US",
            "telephone_number": "847-729-6220",
            "fax_number": "847-729-1116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKOVEN",
        "first_name": "RONNA",
        "name_prefix": "Ms.",
        "credential": "OTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056-000076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1617235",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.