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

Kyle Tanzillo, MOT, OTR/L

Individual provider Occupational Therapist · NPI 1528421187

Kyle Tanzillo, MOT, OTR/L is an Occupational Therapist in Private Practice in Northlake, Illinois. Qualified in 2015, 11 years ago. Practices with Powerback Rehabilitation LLC, a 616-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
11
Licensed in
IL
In the registry since
2016
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

401 W Lake St
Northlake, IL 60164-2435
Phone: (708) 365-9251
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 056011401 (IL)

Record details

NPI number1528421187
Entity typeIndividual (Type 1)
GenderMale
Credentials MOT , OTR/L
Sole proprietorNo
NPI enumeratedMarch 31, 2016
Last updated in NPPESMarch 31, 2016

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Powerback Rehabilitation Llc — 616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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