Active NPI
Jared R King, DPT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1043507494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070019135
- Practice address
- 3059 W 26TH St
Chicago, IL 60623-4131 - Phone
- (773) 696-9050
- NPI assigned
- Jul 6, 2011
- Sex
- Male
- 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 | 070019135 | IL | Primary |
Addresses
Primary practice location
3059 W 26TH St
Chicago, IL 60623-4131
Mailing address
3059 W 26TH St
Chicago, IL 60623-4131
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 |
|---|---|---|---|
| 070019135 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1043507494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3059 W 26TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606234131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3059 W 26TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606234131",
"telephone_number": "773-696-9050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JARED",
"middle_name": "R",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-06",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070019135",
"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 Jan 7, 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.