Active NPI
Peggy Patricia Fornero, PTA
- Physical Therapy Assistant
- Lombard, IL
National Provider Identifier
1023385754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160002352
- Practice address
- 2100 S Finley Rd
Lombard, IL 60148-4830 - Phone
- (630) 495-4000
- NPI assigned
- Nov 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 160002352 | IL | Primary |
Addresses
Primary practice location
2100 S Finley Rd
Lombard, IL 60148-4830
Mailing address
1209 Hillcrest LN
Woodridge, IL 60517-7550
Phone (630) 985-4585
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160002352 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1023385754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 HILLCREST LN",
"city": "WOODRIDGE",
"state": "IL",
"postal_code": "605177550",
"telephone_number": "630-985-4585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 S FINLEY RD",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601484830",
"telephone_number": "630-495-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORNERO",
"first_name": "PEGGY",
"middle_name": "PATRICIA",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-23",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160002352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.