Active NPI
Adam Jay Johnson, OTD
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1316754948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.016357
- Practice address
- 3021 N Sheffield Ave
Chicago, IL 60657-4419 - Phone
- (773) 296-7450
- NPI assigned
- Dec 17, 2024
- 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 | 056.016357 | IL | Primary |
Addresses
Primary practice location
3021 N Sheffield Ave
Chicago, IL 60657-4419
Mailing address
410 W Victoria LN
Arlington HTS, IL 60005-3762
Phone (847) 987-2366
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 |
|---|---|---|---|
| 056.016357 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734393600000",
"number": "1316754948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 W VICTORIA LN",
"city": "ARLINGTON HTS",
"state": "IL",
"postal_code": "600053762",
"telephone_number": "847-987-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3021 N SHEFFIELD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606574419",
"telephone_number": "773-296-7450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ADAM",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-17",
"last_updated": "2024-12-17",
"certification_date": "2024-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.016357",
"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 Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.