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Deactivated NPI 1386976371 Deactivated / Inactive NPI Male Practitioner

Stanley G. Pavesich , COTA, L

Occupational Therapy Assistant • Bradley, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Stanley Pavesich has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 02, 2010
NPI Deactivation Date August 06, 2021
Total Practice Duration ~11 Years of Practice (2010 – 2021)

Professional Overview & Biography Verified Profile Summary

Stanley Pavesich, COTA, L was a registered Occupational Therapy Assistant practicing in Bradley, IL. Throughout an active medical career spanning 11 years, Stanley Pavesich provided care at the practice location at 400 S KENNEDY DR until profile deactivation on 2021-08-06.

Practice Location & Contact Primary Location

Practice Address

400 S Kennedy Dr
Suite 600

Bradley, IL 609152682

Telephone 8159357496
Fax 8159357860
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Occupational Therapy Assistant in Bradley, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.5 Yrs
Regional Practice Density
1 Specialists

Practicing in Bradley, IL (1525 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Occupational Therapy Assistant Primary Specialty

NUCC Taxonomy Code: 224Z00000X

State License IL 057000503

An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Cynthia Provost , MHS, CCC, SLP, L

Speech-Language Pathologist

NPI 1023366036

MHS, Certificate of Clinical Competence, Speech-Language Pathologist, L

Qiana Goosby

Physical Therapist

NPI 1225393440
Anyia White

Behavior Technician

NPI 1386534550
Mary Ann Garcia , PT

Physical Therapist

NPI 1487905352

Physical Therapist

Rebecca Kvasnicka , MOT, OTR, L

Occupational Therapist

NPI 1851627426

Master of Occupational Therapy, Occupational Therapist Registered, L

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 06, 2021

Record deactivated on August 06, 2021

NPI Profile Active February 02, 2010

NPI status registered as active in NPPES database

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Updated Practice Location February 02, 2010

Registered at 400 S KENNEDY DR, SUITE 600, BRADLEY, IL 609152682 (Tel: 8159357496)

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Updated Business Mailing Address February 02, 2010

Registered at 400 S KENNEDY DR, SUITE 600, BRADLEY, IL 609152682 (Tel: 8159357496)

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Provider Name / Credentials Updated February 02, 2010

Recorded as STANLEY PAVESICH, COTA/L

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 02, 2010

Occupational Therapy Assistant (License #057000503 in IL)

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Initial NPI Registration & Enumeration February 02, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1386976371
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 02, 2010
Last Update: February 02, 2010
Deactivation Date: August 06, 2021

Mailing Address

400 S Kennedy Dr, Suite 600

Bradley, IL 609152682

Phone: 8159357496

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.