Alicia M Dirksen, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

227.021975 Issued in IL

Practice address

2536 Farragut Dr
Springfield, IL 62704-1540

Phone

(217) 971-7647

NPI assigned

Mar 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1114502911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2944 FLOWERBROOK CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023321",
            "telephone_number": "217-971-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 FARRAGUT DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041540",
            "telephone_number": "217-971-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKSEN",
        "first_name": "ALICIA",
        "middle_name": "M",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.021975",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "53526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Marie Dinardo, R.PH.
• Elizabeth Anne Dinges, PHARM.D.
• Nancy Lee Dinges
• Marian Dionne, L.C.P.C.
• Randy Dionne, L.C.P.C.
• Dispatch Medical Transport
• Nicole Renee Dissette, PMHNP-BC
• Louis Thomas Distasio, L.AC.
• Mary Beth Ditman, C.F.N.P.
• Rebecca Dix, MD

• Massage Therapist in Springfield, IL
• Providers in Springfield, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.