Faraz Ali Mirza, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.015912 Issued in IL

Practice address

3233 W Addison St
Chicago, IL 60618-4328

Phone

(773) 478-0496

NPI assigned

Apr 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletic and Therapeutic Institute of Naperville, LLCGroup PAC ID 8325014020, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Athletic and Therapeutic Institute of Naperville LLC

  • Physical Therapist
  • Aurora, IL
  • NPI 1023129681
  Medicare reassignment Care Compare group NPD
• Athletic and Therapeutic Institute of Naperville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Hazel Crest, IL
  • NPI 1043952641
  NPD

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1952153058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184328",
            "telephone_number": "773-478-0496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3709 N Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606184503",
            "country_code": "US",
            "telephone_number": "773-377-5492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "FARAZ",
        "middle_name": "ALI",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.015912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirshed Medical Center S C
• Nayeh E Mirshed, M.D.
• Jeffrey Charles Mirsky, M.D.
• Kidus Miruts, MD
• Basil Francis Mirza
• Hajira Mirza
• Irfan A Mirza, MD
• Jadis SD Mirza
• Maria Mirza, LCSW
• Mariam Mirza

• Occupational Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.