Individual provider Active NPI

Jenna Tilton

  • Developmental Therapist
  • Tinley Park, IL
National Provider Identifier
1861639684
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
7722 Greenway Blvd
Unit 1SE
Tinley Park, IL 60487-5580
Phone
(815) 690-1112
NPI assigned
Jan 15, 2009
Last updated
Jun 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

7722 Greenway Blvd
Unit 1SE
Tinley Park, IL 60487-5580

Mailing address

7722 Greenway Blvd
Unit 1SE
Tinley Park, IL 60487-5580
Phone (815) 690-1112

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

NPI Registry JSON

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1861639684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7722 GREENWAY BLVD",
            "address_2": "UNIT 1SE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604875580",
            "telephone_number": "815-690-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7722 GREENWAY BLVD",
            "address_2": "UNIT 1SE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604875580",
            "telephone_number": "815-690-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "JENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.