Active NPI
Jennifer Messerman, C.O.T.A.
- Occupational Therapy Assistant
- Waukegan, IL
National Provider Identifier
1912303215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5374-27
- Practice address
- 1615 Sunset Ave
Waukegan, IL 60087-3810 - Phone
- (847) 244-6700
- NPI assigned
- Nov 13, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057.004171 | IL | |
| Occupational Therapy Assistant | 224Z00000X | 5374-27 | WI | Primary |
Addresses
Primary practice location
1615 Sunset Ave
Waukegan, IL 60087-3810
Mailing address
687 N Dries St
Saukville, WI 53080-1667
Phone (262) 286-5376
Other practice location 1
3014 Erie Ave
Sheboygan, WI 53081-3658
Phone (920) 459-3028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912303215 | Medicaid | IL |
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 |
|---|---|---|---|
| OTA13956 | FL | MD | Occupational Therapy Assistant |
| 057.004171 | IL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781740800000",
"number": "1912303215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "687 N DRIES ST",
"city": "SAUKVILLE",
"state": "WI",
"postal_code": "530801667",
"telephone_number": "262-286-5376",
"fax_number": "800-918-8512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 SUNSET AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600873810",
"telephone_number": "847-244-6700"
}
],
"practiceLocations": [
{
"address_1": "3014 Erie Ave",
"address_purpose": "LOCATION",
"city": "Sheboygan",
"state": "WI",
"postal_code": "530813658",
"country_code": "US",
"telephone_number": "920-459-3028",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MESSERMAN",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "C.O.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-13",
"last_updated": "2026-06-18",
"certification_date": "2026-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IL",
"license": "057.004171",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "5374-27",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912303215",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.