Jennifer Caccomo Matarazzo, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

070015636 Issued in IL

Practice address

4139 N Firestone CT
Hoffman Estates, IL 60192-1701

Phone

(847) 525-9556

Fax

(847) 220-9206

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1831216555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4139 N FIRESTONE CT",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921701",
            "telephone_number": "847-525-9556",
            "fax_number": "847-220-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 N FIRESTONE CT",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921701",
            "telephone_number": "847-525-9556",
            "fax_number": "847-220-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATARAZZO",
        "first_name": "JENNIFER",
        "middle_name": "CACCOMO",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": "070015636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1617235",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheyanne Martin-Medrano
• Kelley Marie Martin, OTR/L
• Samy Yiced Martinez
• Marguerite Martino, L.C.P.C., A.T.R.
• Nicole Marie Masse, M.D.
• Abraham Mathew, M.D.
• Theresa I Mathew, M.D.
• Kimberly Mattes
• Allison Anne Mauro, PSY.D.
• Yanni Maxouris

• Pediatric Physical Therapist in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Pediatric Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.