Shane M Liston, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056012548 Issued in IL

Practice address

2272 95TH St Ste 300
Naperville, IL 60564-8952

Phone

(630) 428-1503

Fax

(630) 428-1542

NPI assigned

Jun 26, 2018

Sex

Male

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)

Enrolled

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1215422837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2272 95TH ST STE 300",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648952",
            "telephone_number": "630-428-1503",
            "fax_number": "630-428-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTON",
        "first_name": "SHANE",
        "middle_name": "M",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale M. Lipe Jr., D.D.S.
• Lisa a Pinto PSYD PC
• Lisa Pisha LLC
• Carly Liskey, RBT-18-48477
• Ann Marie Lisnich, D.D.S.
• Little Bear Pediatric Therapy, LLC
• Little Friends
• Little Friends Center for Autism, Inc.
• Little Friends, Inc.
• Little Lamb Speech Therapy PLLC

• Occupational Therapist in Naperville, IL
• Providers in Naperville, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.