Healthcare Provider Details

I. General information

NPI: 1982096160
Provider Name (Legal Business Name): JENNIFER ADELE JONES MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1488 SUTTON CIR
WAUCONDA IL
60084-3705
US

IV. Provider business mailing address

1488 SUTTON CIR
WAUCONDA IL
60084-3705
US

V. Phone/Fax

Practice location:
  • Phone: 224-343-9912
  • Fax:
Mailing address:
  • Phone: 224-343-9912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number056.010846
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: