Nichole Addo-Stover, COTA
Individual provider Active NPI Occupational Therapy Assistant · Orland Park, IL
NPI 1992924815 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992924815
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 057000986 (IL)
- Practice address
- 16170 Kingsport Rd
Orland Park, IL 60467-5602 - Phone
- (708) 349-6544
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057000986 | IL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quality Therapy & Consultation, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057000986 | IL | Yes |
Addresses
Primary practice location
16170 Kingsport Rd
Orland Park, IL 60467-5602
Mailing address
2820 Western Ave
Park Forest, IL 60466-1803
Phone (708) 349-6544
Other providers in Orland Park, IL
- Acdi Orland Park LLC
- Active Life Chiropractic Center, LTD.
- Active Physical Therapy & Rehabilitation P.C.
- Natalie Adair
- Lorenda Faye Adams
- Martins Adeoye
- Kyle Adkins
- Marisol Dinsay Aduana
- Advance Rehab Services Inc.
- Advanced Allergy & Asthma Care S.C.
All providers in Orland Park, IL · Occupational Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.