Jessica A Mortillaro, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.004296 Issued in IL

Practice address

7400 Augusta St
River Forest, IL 60305-1402

Phone

(708) 209-3620

NPI assigned

Apr 5, 2019

Last updated

Apr 5, 2019By the provider in NPPES

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

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1922560069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 OAKTON ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022722",
            "telephone_number": "847-721-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 AUGUSTA ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051402",
            "telephone_number": "708-209-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTILLARO",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.004296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul David Michaels, D.C.
• Midwest Express Care 2, Inc
• Clara May Miller, R.N.
• William Millman, M.D.
• Gayla M Morales, OTR/L
• Pamela M Mulshine, M.D.
• Jennifer Kirk Munaretto, DMD, MS
• Raymond F Munaretto, D.D.S.
• Richard A Munaretto, D.D.S., M.S.
• Richard Alex Munaretto, D.D.S

• Athletic Trainer in River Forest, IL
• Providers in River Forest, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.