Carolyn Brady, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070024404 Issued in IL

Practice address

430 Milwaukee Ave Ste Aa
Lincolnshire, IL 60069-3016

Phone

(847) 821-8300

Fax

(847) 821-9300

NPI assigned

Jul 20, 2018

Last updated

Oct 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1063999381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W BEHREND DR APT 2146",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086955",
            "telephone_number": "815-721-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MILWAUKEE AVE STE AA",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693016",
            "telephone_number": "847-821-8300",
            "fax_number": "847-821-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Spring St",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "534051667",
            "country_code": "US",
            "telephone_number": "262-687-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADY",
        "first_name": "CAROLYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13345-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P18981",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT30150",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Lincolnshire, IL
• Providers in Lincolnshire, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.