Individual provider Active NPI

Evelina Kristy, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1942896923
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.013898 Issued in IL
Practice address
5256 W Winnemac Ave
Chicago, IL 60630-2218
Phone
(773) 414-2822
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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 056.013898 IL Primary

Addresses

Primary practice location

5256 W Winnemac Ave
Chicago, IL 60630-2218

Mailing address

5256 W Winnemac Ave
Chicago, IL 60630-2218
Phone (773) 414-2822

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
056.013898ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelvic Floor Rehab LLC Occupational Therapist CurrentSince Apr 9, 2023 Accepting new patients

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1942896923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5256 W WINNEMAC AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302218",
            "telephone_number": "773-414-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5256 W WINNEMAC AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302218",
            "telephone_number": "773-414-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTY",
        "first_name": "EVELINA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013898",
            "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 Dec 14, 2020; 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.