Individual provider Active NPI

Jennifer Elizabeth Long, OT

  • Occupational Therapist
  • Naperville, IL
National Provider Identifier
1194234385
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1212 S Naper Blvd Ste 104
Naperville, IL 60540-8398
Phone
(630) 369-2340
Fax
(630) 369-2859
NPI assigned
Sep 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 056003249 IL
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

1212 S Naper Blvd Ste 104
Naperville, IL 60540-8398

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

430 Pennsylvania Ave Ste 240
Glen Ellyn, IL 60137-4464
Phone (630) 450-5060

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlong171853@direct.edward.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171027001905 IL Practitioner - Occupational Therapist in Private Practice 6709152275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1212 S Naper Blvd
Suite 104
Naperville, IL 60540-8398
Phone (630) 369-2340

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
90
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Jan 9, 2023 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Occupational Therapist CurrentSince Feb 6, 2023 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Current Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC CurrentSince Jan 9, 2023 Accepting new patients
Athletic & Therapeutic Institute of Bourbonnais, LLC CurrentSince Feb 6, 2023 Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

1212 S Naper Blvd
Ste 104
Naperville, IL 60540
Phone (630) 369-2340

23915 W Main St
Unit 105
Plainfield, IL 60544
Phone (815) 577-8844

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

16651 Harlem Ave
Tinley Park, IL 60477
Phone (708) 444-2467

967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743

Organizations & group practices 5

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1194234385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 S NAPER BLVD STE 104",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408398",
            "telephone_number": "630-369-2340",
            "fax_number": "630-369-2859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 Pennsylvania Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "Glen Ellyn",
            "state": "IL",
            "postal_code": "601374464",
            "country_code": "US",
            "telephone_number": "630-450-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "IL",
            "license": "056003249",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlong171853@direct.edward.org",
            "affiliation": "N",
            "address_1": "430 Pennsylvania Ave Ste 240",
            "city": "Glen Ellyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601374464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.