Active NPI
Stacey Freitag, LMT
- Massage Therapist
- Joliet, IL
National Provider Identifier
1063231249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.021134
- Practice address
- 310 N Hammes Ave Ste LL7
Joliet, IL 60435-8147 - Phone
- (779) 279-0706
- NPI assigned
- Oct 7, 2024
- Last updated
- Oct 7, 2024
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.021134 | IL | Primary |
Addresses
Primary practice location
310 N Hammes Ave Ste LL7
Joliet, IL 60435-8147
Mailing address
3101 Bloomfield Dr
Joliet, IL 60436-9702
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 |
|---|---|---|---|
| 227.021134 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1063231249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 BLOOMFIELD DR",
"city": "JOLIET",
"state": "IL",
"postal_code": "604369702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 N HAMMES AVE STE LL7",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358147",
"telephone_number": "779-279-0706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREITAG",
"first_name": "STACEY",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-07",
"last_updated": "2024-10-07",
"certification_date": "2024-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.021134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
- Charnea Lashae Fowler
- Latisha Fox
- Julia Catherine Fraczek, MM, LPMT, MT-BC
- Vijaykumar Francis, PT
- Deborah M Freeman, M.D.
- Fresenius Medical Care Joliet Home, LLC (Fresenius Medical Care Joliet Home Dialysis Network)
- Fresenius Medical Care of Plainfield, LLC (Fresenius Medical Care Joliet)
- Kimberly Ann Freund, OTR/L
- Nancy Friedman, PT
- Haley Christine Fritchtnitch
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.