Jodi Lee Carroll, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.009103 Issued in IL

Practice address

1640 N Wells St
# 103
Chicago, IL 60614-6087

Phone

(231) 392-6420

NPI assigned

May 5, 2011

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1417249798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 N WOLCOTT AVE",
            "address_2": "APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 N WELLS ST",
            "address_2": "# 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146087",
            "telephone_number": "231-392-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JODI",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.009103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Carroll, DPT
• Cayama Carroll, MA., LCPC
• Elizabeth Eleanor Carroll, MD
• Emily Barbara Carroll, M.A., L.C.S.W.
• Erin Carroll, LPC
• Julia Carroll, OTR/L
• Kaelyn Carroll, RN, CNM
• Katherine Carroll, M.D.
• Kathryn Kelly Carroll, LCSW
• Kylie Kathleen Carroll, OTR/L

• Occupational Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.