Jamie Lynn Wiatrak

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

2166 Muirfield TRL
Bolingbrook, IL 60490-4911

Phone

(630) 631-6926

NPI assigned

Apr 6, 2018

Last updated

Apr 6, 2018By the provider in NPPES

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)

Not enrolled

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1639676687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2166 MUIRFIELD TRL",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604904911",
            "telephone_number": "630-631-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2166 MUIRFIELD TRL",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604904911",
            "telephone_number": "630-631-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIATRAK",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Therapist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.

Verify at the official NPI Registry.