Individual provider Active NPI

Mike Ramirez, COTA/L

  • Occupational Therapy Assistant
  • Northbrook, IL
National Provider Identifier
1992489751
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.005099 Issued in IL
Practice address
3300 Milwaukee Ave
Northbrook, IL 60062-7126
Phone
(847) 795-9700
NPI assigned
Jun 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.005099 IL Primary

Addresses

Primary practice location

3300 Milwaukee Ave
Northbrook, IL 60062-7126

Mailing address

1255 W Prospect Ave Apt 208
Mount Prospect, IL 60056-2253

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
057.005099ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1992489751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W PROSPECT AVE APT 208",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MILWAUKEE AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627126",
            "telephone_number": "847-795-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "MIKE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.