Individual provider Active NPI

Marion Fides Ruiz

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1972001329
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056011354 Issued in IL
Practice address
5839 W 63Rd St
Chicago, IL 60638-5445
Phone
(872) 600-1689
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 019354 NY
Occupational Therapist 225X00000X 056011354 IL Primary

Addresses

Primary practice location

5839 W 63Rd St
Chicago, IL 60638-5445

Mailing address

5839 W 63Rd St
Chicago, IL 60638-5445
Phone (872) 600-1689

Other names 1

  • Marion Fides C Vallinas Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019354NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Oct 28, 2023 Accepting new patients
Dependable Care Staffing, LLC Occupational Therapist CurrentSince Dec 10, 2023 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Oct 28, 2023 Accepting new patients

Locations

2155 W Pierce Ave
Chicago, IL 60622
Phone (773) 252-2066

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

9933 Lawler Ave
Ste 206B
Skokie, IL 60077
Phone (847) 983-8417

Organizations & group practices 3

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": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1972001329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5839 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606385445",
            "telephone_number": "872-600-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5839 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606385445",
            "telephone_number": "872-600-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "MARION FIDES",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019354",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARION FIDES",
            "last_name": "VALLINAS",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 9, 2024; 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.