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

Nicole M Iwanowski, OTR/L, CLT

Individual provider Occupational Therapist · NPI 1295844603

Nicole M Iwanowski, OTR/L, CLT is an Occupational Therapist in Private Practice in Kenosha, Wisconsin. Qualified in 2004, 22 years ago. Practices with Midwest Orthopedic Specialty Hospital, LLC, a 66-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
22
Licensed in
WI
In the registry since
2006
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

10222 74th St Ste 211
Kenosha, WI 53142-6810
Phone: (262) 925-5020
Fax: (262) 925-5021
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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 4230026 (WI)

Record details

NPI number1295844603
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L , CLT
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESOctober 19, 2017

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Midwest Orthopedic Specialty Hospital, Llc — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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