Active NPI
Julie Jo Johnson, COTA
- Occupational Therapy Assistant
- Homewood, IL
National Provider Identifier
1861554503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 1055 175TH St
Suite 101
Homewood, IL 60430-4610 - Phone
- (312) 238-2161
- Fax
- (708) 957-8353
- NPI assigned
- Dec 15, 2006
- 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 Therapy Assistant | 224Z00000X | IL | Primary |
Addresses
Primary practice location
1055 175TH St
Suite 101
Homewood, IL 60430-4610
Mailing address
18412 Pine Cone Dr
Unit 2
Tinley Park, IL 60477-4885
Phone (312) 238-2161
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057.001573 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861554503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18412 PINE CONE DR",
"address_2": "UNIT 2",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604774885",
"telephone_number": "312-238-2161",
"fax_number": "708-957-8353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 175TH ST",
"address_2": "SUITE 101",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604304610",
"telephone_number": "312-238-2161",
"fax_number": "708-957-8353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JULIE",
"middle_name": "JO",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.