Individual provider Active NPI

Osayama Jacquelyn Omoruyi

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1275490054
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.029624 Issued in IL
Practice address
1220 N State Pkwy # 1600
Chicago, IL 60610-8112
Phone
(562) 751-7009
NPI assigned
Jan 5, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.029624 IL Primary

Addresses

Primary practice location

1220 N State Pkwy # 1600
Chicago, IL 60610-8112

Mailing address

1220 N State Pkwy # 1600
Chicago, IL 60610-8112
Phone (562) 751-7009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260115001590 IL Practitioner - Physical Therapist in Private Practice 7315423753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 W Jefferson St
Suite 2310
Louisville, KY 40202-2881

PO Box
Suite 69211
Baltimore, MD 21264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.029624ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Dec 10, 2025 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Dec 10, 2025 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

Organizations & group practices 2

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": "1767571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1275490054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N STATE PKWY # 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108112",
            "telephone_number": "562-751-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N STATE PKWY # 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108112",
            "telephone_number": "562-751-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMORUYI",
        "first_name": "OSAYAMA",
        "middle_name": "JACQUELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.029624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.