Individual provider Active NPI

Kelly Clor, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1114240397
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-017653 Issued in IL
Practice address
1323 W Diversey Pkwy
Chicago, IL 60614-1207
Phone
(773) 549-2520
Fax
(773) 549-2743
NPI assigned
Mar 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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 070-017653 IL Primary

Addresses

Primary practice location

1323 W Diversey Pkwy
Chicago, IL 60614-1207

Mailing address

1323 W Diversey Pkwy
Chicago, IL 60614-1207
Phone (773) 549-2520

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
070-017653ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1114240397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 W DIVERSEY PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141207",
            "telephone_number": "773-549-2520",
            "fax_number": "773-549-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 W DIVERSEY PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141207",
            "telephone_number": "773-549-2520",
            "fax_number": "773-549-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOR",
        "first_name": "KELLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-017653",
            "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 Mar 2, 2010; 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.