Individual provider Active NPI

Debra Morrisette

  • Physical Therapy Assistant
  • Glenview, IL
National Provider Identifier
1114211547
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160002390 Issued in IL
Practice address
3703 West Lake Avenue
Glenview, IL 60026
Phone
(847) 998-1188
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
No

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.

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

LicenseStateTypeSpecialty
160002390ILMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Comprehensive Group Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160002390 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

3703 West Lake Avenue
Glenview, IL 60026

Mailing address

26429 W Fox Trail
Channahan, IL 60410

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 2, 2011.

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1114211547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26429 W FOX TRAIL",
            "city": "CHANNAHAN",
            "state": "IL",
            "postal_code": "60410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 WEST LAKE AVENUE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "847-998-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISETTE",
        "first_name": "DEBRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160002390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.