Michelle Jenkins, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057002995 Issued in IL

Practice address

15129 Beachview Ter
Dolton, IL 60419-2510

Phone

(708) 638-0654

NPI assigned

Nov 24, 2015

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1326412677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15129 BEACHVIEW TER",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15129 BEACHVIEW TER",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192510",
            "telephone_number": "708-638-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MICHELLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057002995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Howard, CRTT
• Yazmine Nicole Howard, LCSW
• Bohdan Askold Iwanetz, MD
• Lisa Gibson Jackson, M.S. CCC-SLP/L
• Jaroslaus T Iwanetz MD SC
• Nikkita Chennille Johnson-Neealy, LPN
• Quintella Johnson
• Roneisha C Johnson
• Tinesha Denise Johnson
• Yvette Johnson

• All providers in Dolton, IL
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.