Active NPI
Jason Allan Pattengale, OTR/L
- Occupational Therapist
- Lake Zurich, IL
National Provider Identifier
1114385382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.011334
- Practice address
- 900 S Rand Rd
Lake Zurich, IL 60047-2450 - Phone
- (847) 726-1200
- NPI assigned
- Feb 3, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.011334 | IL | Primary |
Addresses
Primary practice location
900 S Rand Rd
Lake Zurich, IL 60047-2450
Mailing address
1400 West St
Apt E10
Union Grove, WI 53182
Phone (262) 909-2185
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 |
|---|---|---|---|
| 056.011334 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1114385382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 WEST ST",
"address_2": "APT E10",
"city": "UNION GROVE",
"state": "WI",
"postal_code": "53182",
"telephone_number": "262-909-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 S RAND RD",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "600472450",
"telephone_number": "847-726-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTENGALE",
"first_name": "JASON",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-03",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.011334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Zurich, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.