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

Mr. Jefferson James Mahinay Licup, OTR/L

Individual provider Occupational Therapist · NPI 1437484110

Mr. Jefferson James Mahinay Licup, OTR/L is an Occupational Therapist in Bolingbrook, Illinois. Licensed in Illinois. Registered with an NPI since 2009.

Licensed in
IL
In the registry since
2009
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

226 Tiger St
Bolingbrook, IL 60490-2053
Phone: (708) 822-8886
Fax: (630) 378-4839
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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 056007185 (IL)

Record details

NPI number1437484110
Entity typeIndividual (Type 1)
GenderMale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedOctober 13, 2009
Last updated in NPPESOctober 13, 2009

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