Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Timothy Anhalt

Individual provider Occupational Therapist · NPI 1962210765

Jacob Timothy Anhalt is an Occupational Therapist in Private Practice in Chicago, Illinois. Qualified in 2024, 2 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2024
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Practice location Address checks out

1725 W Harrison St Ste 440
Chicago, IL 60612-3836
Phone: (312) 563-2454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 056.016355 (IL)

Record details

NPI number1962210765
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 25, 2024
Last updated in NPPESDecember 30, 2024
Certification dateDecember 30, 2024
Mailing address2624 Brookside Ln Apt 805, Schaumburg, IL 60173-6333

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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