Shawnece Lashay Wilson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.005295 Issued in IL

Practice address

10632 Blue Heron Dr
Orland Park, IL 60467-5489

Phone

(708) 910-8272

NPI assigned

Jan 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1063275279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 S PEORIA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433026",
            "telephone_number": "773-226-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10632 BLUE HERON DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675489",
            "telephone_number": "708-910-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHAWNECE",
        "middle_name": "LASHAY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Williams, OTR
• Tasheia Lashay Williams
• Caroline Kreisl Wilson, APN
• Milford Wilson Jr., M.A
• Richard A Wilson, D.O.
• Tiffany Wilson, M.D.
• Megan Win, OTD, OTR/L
• Winterset Dental Care PC
• Sarah Ann Wirtz, OTD, OTR/L
• Patricia Witvoet, LCPC, NCC

• Occupational Therapy Assistant in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.