Individual provider Active NPI

Kenneth Michael Orr Jr., P.T.

  • Physical Therapist
  • Oak Lawn, IL
National Provider Identifier
1053475103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
9618 Southwest Hwy
Oak Lawn, IL 60453-2862
Phone
(708) 229-0101
Fax
(708) 229-0090
NPI assigned
Dec 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

9618 Southwest Hwy
Oak Lawn, IL 60453-2862

Mailing address

2514 Burr Oak Ave
Blue Island, IL 60406-2027
Phone (708) 715-2335

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

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053475103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 BURR OAK AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062027",
            "telephone_number": "708-715-2335",
            "fax_number": "708-229-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9618 SOUTHWEST HWY",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532862",
            "telephone_number": "708-229-0101",
            "fax_number": "708-229-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORR",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.