Illinois licenses occupational therapists and occupational therapy assistants through the Department of Financial and Professional Regulation (IDFPR). New graduates apply by "acceptance of exam"; therapists licensed elsewhere apply by endorsement. Everything below comes from the board's own pages and rules, checked October 18, 2026. Fees and rules change, so confirm on the linked pages before you pay.
Check with your board. OT Ticket is a study aid, not clinical or legal guidance. Not affiliated with, endorsed by or connected to the National Board for Certification in Occupational Therapy (NBCOT), AOTA, ACOTE, the OT Compact Commission or any state board; NBCOT, OTR and COTA are their marks, used here only to name the exam.
Illinois at a glance
Occupational therapist (OT)
OT assistant (OTA)
Exam
NBCOT OTR exam (180 questions, 4 hours), $540 to NBCOT
NBCOT COTA exam (190 questions, 4 hours), $540 to NBCOT
Board fees
$25 application (68 Ill. Adm. Code 1315.130), non-refundable
$25
Background check
No fingerprint step listed in IDFPR's qualifications sheet; check with IDFPR
Same
Work before the exam
Letter of authorization: OT on site at least 75% of your hours, 6 months to pass
Same
OT Compact
Not a member. An OT Compact bill has been filed but not enacted; you need a full Illinois license. (OT Compact, checked October 18, 2026)
Illinois, step by step
Illinois Department of Financial and Professional Regulation (IDFPR), Occupational Therapy
Education: a master's degree or higher (OT) or an associate degree (OTA) from an ACOTE-accredited program. Upload your official sealed transcript in the application.
Apply in CORE with the $25 application fee.
NBCOT score: OTs need the OTR exam, OTAs the COTA exam. IDFPR staff retrieve your score from NBCOT's portal while they evaluate your application.
Letter of authorization (optional): if you meet every requirement except the exam, you can ask for a letter that lets you practice under supervision, with a licensed OT on site for at least 75% of your work hours. You have six months from the letter to pass. It is not a license.
After licensure: every Illinois OT license expires December 31 of each odd-numbered year, whenever it was issued. Illinois is not yet in the OT Compact (a bill has been filed).
Every state licenses occupational therapists and OT assistants on NBCOT certification: an ACOTE-accredited degree with its Level II fieldwork, then NBCOT's exam (the OTR exam for OTs, 180 questions in 4 hours; the COTA exam for OT assistants, 190 questions in 4 hours; 450 on a 300-600 scale passes; $540 to apply online). NBCOT certification is not a license: you apply to your state board separately, and NBCOT sends the board your score (the Score Transfer is free if you add it when you apply for the exam, $35 later). The full walk-through: How to get your OT license.