Individual provider Active NPI

Jean M Callicoat, COTA

  • Occupational Therapy Assistant
  • Joliet, IL
National Provider Identifier
1629100193
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
823 129TH Infantry Dr
Suite 104
Joliet, IL 60435-8346
Phone
(815) 729-2999
Fax
(815) 729-1950
NPI assigned
Mar 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X IL Primary

Addresses

Primary practice location

823 129TH Infantry Dr
Suite 104
Joliet, IL 60435-8346

Mailing address

137 Fir St
New Lenox, IL 60451-1428
Phone (815) 485-0032

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

LicenseStateTypeSpecialty
057.001850ILMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Hand Care Past Accepting new patients
Midwest Hand Care, Inc. PastSince Dec 20, 2004 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629100193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 FIR ST",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511428",
            "telephone_number": "815-485-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 129TH INFANTRY DR",
            "address_2": "SUITE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358346",
            "telephone_number": "815-729-2999",
            "fax_number": "815-729-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLICOAT",
        "first_name": "JEAN",
        "middle_name": "M",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.