Active NPI
Cynthia L Jacobson, OTR/L , M.ED
- Occupational Therapist
- Maywood, IL
National Provider Identifier
1639738461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.000829
- Practice address
- 1000 Van Buren St
Maywood, IL 60153-1970 - Phone
- (708) 234-8883
- NPI assigned
- Jun 5, 2019
- 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 | 056.000829 | IL | Primary |
Addresses
Primary practice location
1000 Van Buren St
Maywood, IL 60153-1970
Mailing address
14 N Peoria St Apt 4H
Chicago, IL 60607-2648
Phone (312) 733-0511
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.000829 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1639738461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 N PEORIA ST APT 4H",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606072648",
"telephone_number": "312-733-0511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 VAN BUREN ST",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601531970",
"telephone_number": "708-234-8883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "CYNTHIA",
"middle_name": "L",
"credential": "OTR/L , M.ED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-05",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.000829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.