Individual provider Active NPI

Krina Dedhia, MPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1104374990
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070022154 Issued in IL
Practice address
5764 S Archer Ave
Chicago, IL 60638-1643
Phone
(773) 284-0888
Fax
(773) 284-0880
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070022154 IL Primary

Addresses

Primary practice location

5764 S Archer Ave
Chicago, IL 60638-1643

Mailing address

5764 S Archer Ave
Chicago, IL 60638-1643
Phone (773) 284-0888

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

LicenseStateTypeSpecialty
070022154ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Home Health Care, Inc PastSince Sep 16, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1104374990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381643",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5764 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381643",
            "telephone_number": "773-284-0888",
            "fax_number": "773-284-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDHIA",
        "first_name": "KRINA",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070022154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.