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

Ryan Jackson, COTA/L

Individual provider Occupational Therapy Assistant · NPI 1164989257

Ryan Jackson, COTA/L is an Occupational Therapy Assistant in Itasca, Illinois. Licensed in Illinois. Registered with an NPI since 2019.

Licensed in
IL
In the registry since
2019
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

535 S Elm St
Itasca, IL 60143-2187
Phone: (630) 773-9416
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 057005112 (IL)

Record details

NPI number1164989257
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA/L
Sole proprietorNo
NPI enumeratedFebruary 25, 2019
Last updated in NPPESFebruary 25, 2019
Mailing address19438 Elm Dr, Country Club Hills, IL 60478-5856

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