Active NPI
Jordan Marie Maisto, OTR/L
- Occupational Therapist
- Roselle, IL
National Provider Identifier
1467942763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.012498
- Practice address
- 333 W Irving Park Rd Ste 206
Roselle, IL 60172 - Phone
- (630) 893-7995
- NPI assigned
- May 14, 2018
- Last updated
- May 14, 2018
- Sex
- Female
- 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 | 056.012498 | IL | Primary |
Addresses
Primary practice location
333 W Irving Park Rd Ste 206
Roselle, IL 60172
Mailing address
40W310 la Fox Rd
Saint Charles, IL 60175
Phone (630) 444-0077
Other practice location 1
40W310 La Fox Rd
Saint Charles, IL 60175
Phone (630) 444-0077
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 |
|---|---|---|---|
| 056.012498 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Therapy Corp | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Community Therapy Services
- Speech-Language Pathologist
- St Charles, IL
- NPI 1336609684
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526256000000",
"number": "1467942763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40W310 LA FOX RD",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "60175",
"telephone_number": "630-444-0077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 W IRVING PARK RD STE 206",
"city": "ROSELLE",
"state": "IL",
"postal_code": "60172",
"telephone_number": "630-893-7995"
}
],
"practiceLocations": [
{
"address_1": "40W310 La Fox Rd",
"address_purpose": "LOCATION",
"city": "Saint Charles",
"state": "IL",
"postal_code": "60175",
"country_code": "US",
"telephone_number": "630-444-0077",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAISTO",
"first_name": "JORDAN",
"middle_name": "MARIE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-14",
"last_updated": "2018-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.012498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roselle, IL
- Little Tikes Therapy, Inc
- Brainard G Llanes, D.D.S.
- Jeffrey Daniel Lundgren Sr., RPH
- Jane Madaj, IBCLC,RLC
- Kelsey Madaj, LMFT
- Elizabeth A Malouf, MT-BC, QSP
- Marsico Enterprises, LLC (Right at Home - West Suburban Chicago)
- Max Care Behavioral Health Services Professional Corporation
- Max Care Home Health Services Inc.
- Max Care Transportation Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.