Active NPI
Kristen M Streeter, ATC
- Athletic Trainer
- Champaign, IL
National Provider Identifier
1083609903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096-001120
- Practice address
- 2040 S Neil St
Champaign, IL 61820-7220 - Phone
- (217) 352-3330
- Fax
- (217) 352-4616
- NPI assigned
- Sep 16, 2005
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096-001120 | IL | Primary |
Addresses
Primary practice location
2040 S Neil St
Champaign, IL 61820-7220
Mailing address
2040 S Neil St
Champaign, IL 61820-7220
Phone (217) 352-3330
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 |
|---|---|---|---|
| 096-001120 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1083609903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 S NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207220",
"telephone_number": "217-352-3330",
"fax_number": "217-352-4616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 S NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207220",
"telephone_number": "217-352-3330",
"fax_number": "217-352-4616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STREETER",
"first_name": "KRISTEN",
"middle_name": "M",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096-001120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.