IndividualActive
Nicole Lavanway, COTA
NPI 1326626334 · Occupational Therapy Assistant · Peru, IL
Provider details
- NPI number
- 1326626334
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA
- Sex
- Female
- Sole proprietor
- No
- License
- 057005551 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1301 21st St
Peru, IL 61354-1359
Phone: (815) 223-4901
Street-level locationGet directions
Mailing address
712 N 1st St
Princeton, IL 61356-1212
Registry dates
- Enumerated
- 2021-03-31
- Last updated
- 2021-03-31
- Certified
- 2021-03-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.