Active NPI
Kelsey Brucks, PT, DPT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1013319573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.020963
- Practice address
- 1725 S Wabash Ave
Chicago, IL 60616-1219 - Phone
- (612) 922-2777
- NPI assigned
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.020963 | IL | Primary |
Addresses
Primary practice location
1725 S Wabash Ave
Chicago, IL 60616-1219
Mailing address
1725 S Wabash Ave
Chicago, IL 60616-1219
Phone (612) 922-2777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.020963 | IL | MD | Physical Therapist |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DCJFCD/Endpoint/DCJFCD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1013319573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 S WABASH AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606161219",
"telephone_number": "612-922-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 S WABASH AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606161219",
"telephone_number": "612-922-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCKS",
"first_name": "KELSEY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.020963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.