Individual provider Active NPI

Sherry Oliphant, MT

  • Massage Therapist
  • Chicago, IL
National Provider Identifier
1356928915
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227008617 Issued in IL
Practice address
111 W Jackson Blvd
Chicago, IL 60604-3589
Phone
(773) 617-2294
NPI assigned
Mar 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227008617 IL Primary

Addresses

Primary practice location

111 W Jackson Blvd
Chicago, IL 60604-3589

Mailing address

111 W Jackson Blvd Ste 17
Chicago, IL 60604-3589

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Chicago Direct

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
227008617ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616889600000",
    "number": "1356928915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD STE 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043589",
            "telephone_number": "773-617-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIPHANT",
        "first_name": "SHERRY",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-28",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227008617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "111 W Jackson Blvd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606043589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 28, 2021; 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.