Active NPI
Michael C Karom Jr., PT
- Physical Therapist
- Algonquin, IL
National Provider Identifier
1073784039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070002497
- Practice address
- 2375 S Randall Rd
Algonquin, IL 60102-5922 - Phone
- (708) 670-4216
- Fax
- (224) 333-5747
- NPI assigned
- Mar 18, 2008
- 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 | 070002497 | IL | Primary |
Addresses
Primary practice location
2375 S Randall Rd
Algonquin, IL 60102-5922
Mailing address
1015 Fairfax LN
South Elgin, IL 60177-2748
Phone (847) 695-7453
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070002497 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368662400000",
"number": "1073784039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 FAIRFAX LN",
"city": "SOUTH ELGIN",
"state": "IL",
"postal_code": "601772748",
"telephone_number": "847-695-7453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 S RANDALL RD",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601025922",
"telephone_number": "708-670-4216",
"fax_number": "224-333-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAROM",
"first_name": "MICHAEL",
"middle_name": "C",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-18",
"last_updated": "2013-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070002497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.