Active NPI
John Doughty
- Occupational Therapist
- Lincolnshire, IL
National Provider Identifier
1215567078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056012822
- Practice address
- 800 Audubon Way
Lincolnshire, IL 60069-3811 - Phone
- (847) 865-8811
- NPI assigned
- Jan 21, 2020
- Last updated
- Jan 21, 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 | 056012822 | IL | Primary |
Addresses
Primary practice location
800 Audubon Way
Lincolnshire, IL 60069-3811
Mailing address
536 Old Howell Rd
Greenville, SC 29615-1969
Phone (864) 244-3626
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 |
|---|---|---|---|
| 056012822 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579564800000",
"number": "1215567078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "536 OLD HOWELL RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296151969",
"telephone_number": "864-244-3626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 AUDUBON WAY",
"city": "LINCOLNSHIRE",
"state": "IL",
"postal_code": "600693811",
"telephone_number": "847-865-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGHTY",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-21",
"last_updated": "2020-01-21",
"certification_date": "2020-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056012822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincolnshire, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.