Active NPI
Jayne Sutcliffe, PT
- Physical Therapist
- Minooka, IL
National Provider Identifier
1053503862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1010 S Ridge Rd
Minooka, IL 60447-8810 - Phone
- (815) 521-4400
- Fax
- (815) 521-9709
- NPI assigned
- Aug 15, 2007
- Sex
- Female
- 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 | IL | Primary |
Addresses
Primary practice location
1010 S Ridge Rd
Minooka, IL 60447-8810
Mailing address
1010 S Ridge Road
Minooka, IL 60433
Phone (815) 521-4400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040902000157 | IL | Practitioner - Physical Therapist in Private Practice | 9032184098 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.009156 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1053503862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 S RIDGE ROAD",
"city": "MINOOKA",
"state": "IL",
"postal_code": "60433",
"telephone_number": "815-521-4400",
"fax_number": "815-521-9709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 S RIDGE RD",
"city": "MINOOKA",
"state": "IL",
"postal_code": "604478810",
"telephone_number": "815-521-4400",
"fax_number": "815-521-9709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTCLIFFE",
"first_name": "JAYNE",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minooka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.