Julie M Leidecker LTD

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

JULIE M LEIDECKER LTD

Practice address

586 William R Latham Sr Dr Ste 6B
Bourbonnais, IL 60914-2338

Phone

(815) 935-0540

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Cindy Gerard

Title

Office Manger

Phone

(815) 935-0540

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• A STEP AHEAD PEDIATRIC THERAPY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christina Anderson, PT

  • Physical Therapist
  • Bourbonnais, IL
  • NPI 1861543068
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1023239142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 WILLIAM R LATHAM SR DR STE 6B",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142338",
            "telephone_number": "815-935-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 WILLIAM R LATHAM SR DR STE 6B",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142338",
            "telephone_number": "815-935-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE M LEIDECKER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "GERARD",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "815-935-0540"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "J LEIDECKER NPI",
            "identifier": "1447301643",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C ANDERSON NPI",
            "identifier": "1861543068",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C ANDERSON",
            "identifier": "341746853001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358701965001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A STEP AHEAD PEDIATRIC THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Johnston, LPC
• Jojo Saysons Physical Therapy and Rehabilitation LLC
• Jon Dodds PHD LCPC LTD
• Roy E Jonas, MD
• Dorothy Ann Jones, M.S. CCC-SLP
• Snigdha Kalidindi
• Elizabeth Kalwinski
• Carly Kaminke, PA-C
• Brandi Kaye Kaner
• Kankakee Radiation Oncology LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.