Individual provider Active NPI

Jane Marie Flynn, OTR/L

  • Occupational Therapist
  • Elgin, IL
National Provider Identifier
1003851080
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
102950 Issued in MN
Practice address
750 Fletcher Dr Ste 304
Elgin, IL 60123-4756
Phone
(847) 888-3131
Fax
(847) 888-3359
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 102950 MN Primary

Addresses

Primary practice location

750 Fletcher Dr Ste 304
Elgin, IL 60123-4756

Mailing address

750 Fletcher Dr Ste 304
Elgin, IL 60123-4756
Phone (847) 888-3131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081230000048 IL Practitioner - Occupational Therapist in Private Practice 5395739544

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

750 Flecther Dr
Suite 304
Elgin, IL 60123-4756

750 Fletcher Dr
Elgin, IL 60123-4703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1003851080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 FLETCHER DR STE 304",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234756",
            "telephone_number": "847-888-3131",
            "fax_number": "847-888-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 FLETCHER DR STE 304",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234756",
            "telephone_number": "847-888-3131",
            "fax_number": "847-888-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "JANE",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "102950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.