Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kyle John Blievernicht, MOT

Individual provider Occupational Therapist · NPI 1154970721

Kyle John Blievernicht, MOT is an Occupational Therapist in Private Practice in Glen Carbon, Illinois. Qualified in 2019, 7 years ago. Practices with Empowerme Rehabilitation Illinois LLC, a 367-clinician group and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019

Practice location Address checks out

4955 S State Route 159 Ste B
Glen Carbon, IL 62034-1907
Phone: (618) 288-4677
Fax: (618) 288-4699
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X

Record details

NPI number1154970721
Entity typeIndividual (Type 1)
GenderMale
Credentials MOT
Sole proprietorNo
NPI enumeratedSeptember 6, 2019
Last updated in NPPESSeptember 6, 2019
Mailing address4955 S State Route 159 Ste B, Glen Carbon, IL 62034-1907

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Empowerme Rehabilitation Illinois Llc — 367 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Glen Carbon