Active NPI
Justine Kaminski
- Physical Therapist
- Bloomingdale, IL
National Provider Identifier
1104478312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070024371
- Practice address
- 220 Springfield Dr Ste 300
Bloomingdale, IL 60108-2215 - Phone
- (630) 469-9200
- NPI assigned
- Jul 9, 2019
- Sex
- Female
- 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 | 070024371 | IL | Primary |
Addresses
Primary practice location
220 Springfield Dr Ste 300
Bloomingdale, IL 60108-2215
Mailing address
1860 Payshere Circle
Chicago, IL 60674-2057
Phone (630) 432-6200
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 |
|---|---|---|---|
| 070024371 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1104478312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 PAYSHERE CIRCLE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742057",
"telephone_number": "630-432-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 SPRINGFIELD DR STE 300",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082215",
"telephone_number": "630-469-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMINSKI",
"first_name": "JUSTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-09",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070024371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.