Active NPI
Jackelyn Sheree Jones, OTR
- Occupational Therapist
- Chicago, IL
National Provider Identifier
1609331966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056012321
- Practice address
- 4505 S Drexel Blvd
Chicago, IL 60653-4301 - Phone
- (773) 285-0550
- NPI assigned
- Jan 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 056012321 | IL | Primary |
Addresses
Primary practice location
4505 S Drexel Blvd
Chicago, IL 60653-4301
Mailing address
3420 Western Ave
Park Forest, IL 60466-1839
Phone (708) 752-6595
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 |
|---|---|---|---|
| 056012321 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548892800000",
"number": "1609331966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3420 WESTERN AVE",
"city": "PARK FOREST",
"state": "IL",
"postal_code": "604661839",
"telephone_number": "708-752-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4505 S DREXEL BLVD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606534301",
"telephone_number": "773-285-0550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "JACKELYN",
"middle_name": "SHEREE",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-31",
"last_updated": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056012321",
"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 Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.