Individual provider Active NPI

Jon G. Rusco, MS OTR/L

  • Pediatric Occupational Therapist
  • Downers Grove, IL
National Provider Identifier
1730214529
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056.003050 Issued in IL
Practice address
3551 Highland Ave
Health and Wellness Center
Downers Grove, IL 60515-2100
Phone
(630) 275-1284
Fax
(630) 275-2698
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 056.003050 IL Primary

Addresses

Primary practice location

3551 Highland Ave
Health and Wellness Center
Downers Grove, IL 60515-2100

Mailing address

3551 Highland Ave
Health and Wellness Center
Downers Grove, IL 60515-2100
Phone (630) 275-1284

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 Science

State licenses

LicenseStateTypeSpecialty
056.003050ILMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1730214529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 HIGHLAND AVE",
            "address_2": "HEALTH AND WELLNESS CENTER",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152100",
            "telephone_number": "630-275-1284",
            "fax_number": "630-275-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 HIGHLAND AVE",
            "address_2": "HEALTH AND WELLNESS CENTER",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152100",
            "telephone_number": "630-275-1284",
            "fax_number": "630-275-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSCO",
        "first_name": "JON",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056.003050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.