Active NPI
Stephanie L Olson
- Occupational Therapist
- Crystal Lake, IL
National Provider Identifier
1972757425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.002469
- Practice address
- 411 E Congress Pkwy
Suite B
Crystal Lake, IL 60014-6247 - Phone
- (815) 459-3810
- NPI assigned
- Nov 11, 2008
- Last updated
- Nov 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.002469 | IL | Primary |
Addresses
Primary practice location
411 E Congress Pkwy
Suite B
Crystal Lake, IL 60014-6247
Mailing address
411 E. Congress Parkway
Suite B
Crystal Lake, IL 60014
Phone (815) 459-3810
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.002469 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestones Therapy Center P.C. | Occupational Therapist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Occupational Therapist
- Crystal Lake, IL
- NPI 1275792616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226361600000",
"number": "1972757425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 E. CONGRESS PARKWAY",
"address_2": "SUITE B",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "60014",
"telephone_number": "815-459-3810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 E CONGRESS PKWY",
"address_2": "SUITE B",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600146247",
"telephone_number": "815-459-3810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "STEPHANIE",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-11",
"last_updated": "2008-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.002469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.