Cobb Medical LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

COBB MEDICAL LLC

Practice address

805 Willow Dr
Chicago Heights, IL 60411-2128

Phone

(708) 928-0780

NPI assigned

Jun 24, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Nyerere CobbNPI 1659737195

Title

Owner

Phone

(708) 928-0780

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nyerere Wert Cobb

  • Gerontology Occupational Therapist
  • Chicago Heights, IL
  • NPI 1659737195
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1679317689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 WILLOW DR",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112128",
            "telephone_number": "708-928-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 WILLOW DR",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112128",
            "telephone_number": "708-928-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "NYERERE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-928-0780",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Heights School District 170
• Chicago Heights SLF, LLC
• Chicago Vamc
• Yang K Chun, M.D.
• City of Chicago Heights
• Nyerere Wert Cobb
• Gregg S Coccaro, M.D.
• Fairouz Carpizo Codina, M.D.
• Mario Cole
• Kendralyn Coleman

• Occupational Therapist in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.