Provider Demographics
NPI:1780994756
Name:HINSON, JASON C (OTR/L)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:C
Last Name:HINSON
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:630-575-6250
Mailing Address - Fax:630-575-7450
Practice Address - Street 1:323 N BREIEL BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3868
Practice Address - Country:US
Practice Address - Phone:513-420-1700
Practice Address - Fax:513-420-9700
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY264889225X00000X
IL056006714225X00000X
MO2001032335225X00000X
OHOT011134225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL056006714OtherILLINOIS DIVISION OF PROFESSIONAL REGULATION
MO2001032335OtherMISSOURI BOARD OF OCCUPATIONAL THERAPY