Individual provider Active NPI

Jennifer Messerman, C.O.T.A.

  • Occupational Therapy Assistant
  • Waukegan, IL
National Provider Identifier
1912303215
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5374-27 Issued in WI
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

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1912303215MedicaidIL

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

LicenseStateTypeSpecialty
OTA13956FLMDOccupational Therapy Assistant
057.004171ILMDOccupational 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.

Verify at the official NPI Registry.