Austynne Newberg Boulton, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.012332 Issued in IL

Practice address

1585 N Milwaukee Ave Ste 101
Libertyville, IL 60048-1359

Phone

(847) 918-7947

NPI assigned

Jan 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Austynne Margaret Newberg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rci (WRS), LLC.

  • Rehabilitation Clinic/Center
  • Chicago, IL
  • NPI 1033723101
  NPD (past)
• TJ Corporation I LLC

  • Physical Therapy Clinic/Center
  • Chicago, IL
  • NPI 1063417046
  NPD (past)

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1992203525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 FOREST FORK CT",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 N MILWAUKEE AVE STE 101",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481359",
            "telephone_number": "847-918-7947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 N Rand Rd",
            "address_purpose": "LOCATION",
            "city": "North Barrington",
            "state": "IL",
            "postal_code": "600101496",
            "country_code": "US",
            "telephone_number": "847-756-2680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULTON",
        "first_name": "AUSTYNNE",
        "middle_name": "NEWBERG",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.012332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUSTYNNE",
            "last_name": "NEWBERG",
            "middle_name": "MARGARET",
            "credential": "MOT, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karina Bortnik, PSY.D.
• Bosco Chiropractic Clinic PC
• Dino G Bosco, D.C.
• Holly C Bosier, LCPC
• Kirsten Botello
• Oksana Boykovska, FNP
• Emily Elizabeth Bradof
• Shailly Brahmakshatriya, FNP
• Brain-Eye Evolution at 730 North
• Penny Brantley, FNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.