Stacy Kirsten Summers, P.T.A

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

160005625 Issued in IL

Practice address

1136 N Mill St
Naperville, IL 60563-3577

Phone

(630) 355-3300

NPI assigned

Jan 10, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacy Kirsten Haglund Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1013254002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 N MILL ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633577",
            "telephone_number": "630-355-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 N MILL ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633577",
            "telephone_number": "630-355-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "STACY",
        "middle_name": "KIRSTEN",
        "name_prefix": "Mrs.",
        "credential": "P.T.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "160005625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "HAGLUND",
            "middle_name": "KIRSTEN",
            "credential": "P.T.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Sultan, PHARM D
• Meghan Suman, OT
• Arianna Rose Summa, BCBA
• Rachel Anne Summers, LCSW
• Samantha Summers, PT, DPT
• Summit Medical Care, LLC
• Summit Therapy and Rehabilitation, LLC
• Shannon Summitt
• Sun Dental Care PC
• Christina Terese Sun Oo, LCPC

• Physical Therapist in Naperville, IL
• Providers in Naperville, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.