Individual provider Active NPI

Estherlyn Maymon, MPA, OTR/L

  • Neurorehabilitation Occupational Therapist
  • Chicago, IL
National Provider Identifier
1033161252
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
License
056001169 Issued in IL
Practice address
820 S Damen Ave
PM&R #117
Chicago, IL 60612-3728
Phone
(312) 569-7956
Fax
(312) 569-7956
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 056001169 IL Primary

Addresses

Primary practice location

820 S Damen Ave
PM&R #117
Chicago, IL 60612-3728

Mailing address

820 S Damen Ave
PMR#117
Chicago, IL 60612-3728
Phone (312) 569-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
056001169ILMDNeurorehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1033161252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "address_2": "PMR#117",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-7956",
            "fax_number": "312-569-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "address_2": "PM&R #117",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-7956",
            "fax_number": "312-569-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYMON",
        "first_name": "ESTHERLYN",
        "name_prefix": "Ms.",
        "credential": "MPA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "IL",
            "license": "056001169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.