Active NPI
Bradley W. Jones, OTR L
- Pediatric Occupational Therapist
- Northbrook, IL
National Provider Identifier
1114058302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 056 003367
- Practice address
- 3000 Dundee Rd
Suite 418
Northbrook, IL 60062-2422 - Phone
- (847) 480-7833
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 056 003367 | IL | Primary |
Addresses
Primary practice location
3000 Dundee Rd
Suite 418
Northbrook, IL 60062-2422
Mailing address
3000 Dundee Rd
Suite 418
Northbrook, IL 60062-2422
Phone (847) 480-7833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01633043 | Other | IL | BC BS OF IL PROVIDER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056 003367 | IL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brad Jones Progressive Pediatrics PC | Past | 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.
-
- Public Health or Welfare Agency
- Northbrook, IL
- NPI 1851410062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1114058302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 DUNDEE RD",
"address_2": "SUITE 418",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622422",
"telephone_number": "847-480-7833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 DUNDEE RD",
"address_2": "SUITE 418",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622422",
"telephone_number": "847-480-7833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "BRADLEY",
"middle_name": "W.",
"credential": "OTR L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IL",
"license": "056 003367",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF IL PROVIDER",
"identifier": "01633043",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.