Kevin Minhkha To, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

190 S Prospect Ave
Elmhurst, IL 60126-3271

Phone

(630) 617-3707

NPI assigned

Jan 28, 2019

Last updated

Jun 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1033673678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 HOMESTEAD RD APT F",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261161",
            "telephone_number": "323-245-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S PROSPECT AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263271",
            "telephone_number": "630-617-3707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3532 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925046322",
            "country_code": "US",
            "telephone_number": "323-245-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TO",
        "first_name": "KEVIN",
        "middle_name": "MINHKHA",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-28",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.