Individual provider Active NPI

Jessica L Siegman, OTR/L

  • Pediatric Occupational Therapist
  • Evanston, IL
National Provider Identifier
1043609746
Registry record updated Jan 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056010039 Issued in IL
Practice address
9120 E Prairie Rd
Evanston, IL 60203-1618
Phone
(847) 651-3257
NPI assigned
Jan 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 056010039 IL Primary

Addresses

Primary practice location

9120 E Prairie Rd
Evanston, IL 60203-1618

Mailing address

9120 E Prairie Rd
Evanston, IL 60203-1618
Phone (847) 651-3257

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
056010039ILMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
O.T. to You Pediatric Therapy Services, LLC CurrentSince Jan 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421539200000",
    "number": "1043609746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 E PRAIRIE RD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602031618",
            "telephone_number": "847-651-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 E PRAIRIE RD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602031618",
            "telephone_number": "847-651-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGMAN",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-18",
        "last_updated": "2015-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056010039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2015; 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.