Active NPI
Darryl Jenkins
- Occupational Therapist
- Algonquin, IL
National Provider Identifier
1215558333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056004911
- Practice address
- 9 Hithergreen CT
Algonquin, IL 60102-6288 - Phone
- (312) 804-1030
- NPI assigned
- Apr 29, 2020
- Last updated
- Apr 29, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056004911 | IL | Primary |
Addresses
Primary practice location
9 Hithergreen CT
Algonquin, IL 60102-6288
Mailing address
9 Hithergreen CT
Algonquin, IL 60102-6288
Phone (312) 804-1030
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 |
|---|---|---|---|
| 056004911 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588118400000",
"number": "1215558333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 HITHERGREEN CT",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601026288",
"telephone_number": "312-804-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 HITHERGREEN CT",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601026288",
"telephone_number": "312-804-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "DARRYL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-29",
"last_updated": "2020-04-29",
"certification_date": "2020-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056004911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.