Individual provider Active NPI

Edward Jossue Vaquedano

  • Occupational Therapist
  • Northbrook, IL
National Provider Identifier
1174481485
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1000 Sunset Ridge Rd
Northbrook, IL 60062-4008
Phone
(224) 326-2600
NPI assigned
Jan 14, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X IL Primary

Addresses

Primary practice location

1000 Sunset Ridge Rd
Northbrook, IL 60062-4008

Mailing address

1223 Elder CT
Wheeling, IL 60090-2215
Phone (847) 971-9683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260319001673 IL Practitioner - Occupational Therapist in Private Practice 6800370685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortlyn Therapy PCGroup PAC ID 8729495684, 141 clinicians

Practice addresses (Care Compare)

1000 Sunset Ridge Rd
Northbrook, IL 60062-4008
Phone (224) 300-7284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cortlyn Therapy, PC Occupational Therapist CurrentSince Feb 9, 2026 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": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1174481485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 ELDER CT",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600902215",
            "telephone_number": "847-971-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SUNSET RIDGE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624008",
            "telephone_number": "224-326-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAQUEDANO",
        "first_name": "EDWARD",
        "middle_name": "JOSSUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.