Active NPI
Tamrah Ann Corneliusen, PT
- Physical Therapist
- Naperville, IL
National Provider Identifier
1104534734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.007742
- Practice address
- 2255 Monarch Dr
Naperville, IL 60563-4164 - Phone
- (630) 300-1261
- NPI assigned
- Nov 14, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.007742 | IL | Primary |
Addresses
Primary practice location
2255 Monarch Dr
Naperville, IL 60563-4164
Mailing address
2255 Monarch Dr
Naperville, IL 60563-4164
Phone (630) 300-1261
Other names 1
- Tammy Ann Corneliusen
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1104534734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2255 MONARCH DR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605634164",
"telephone_number": "630-300-1261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2255 MONARCH DR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605634164",
"telephone_number": "630-300-1261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNELIUSEN",
"first_name": "TAMRAH",
"middle_name": "ANN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-14",
"last_updated": "2022-11-14",
"certification_date": "2022-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.007742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TAMMY",
"last_name": "CORNELIUSEN",
"middle_name": "ANN",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.