Theresa Ann Knoll, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60736405 Issued in WA

Practice address

3475 S Alpine Rd
Physicians Immediate Care
Rockford, IL 61109-2604

Phone

(815) 874-8000

Fax

(815) 874-7525

NPI assigned

Dec 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Theresa Ann Yanik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  NPD (past)

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1124264478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SE PIONEER WAY",
            "address_2": "STE 2",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775705",
            "telephone_number": "360-679-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 S ALPINE RD",
            "address_2": "PHYSICIANS IMMEDIATE CARE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092604",
            "telephone_number": "815-874-8000",
            "fax_number": "815-874-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOLL",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "8149",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017118",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60736405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "769380",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP #",
            "identifier": "10115176",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "YANIK",
            "middle_name": "ANN",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Joseph Kmieciak Jr., PHARMD
• Milos Knezevic, PHARM D.
• Sandra Knezevic
• Tess Knight, LPC
• Sarah F Knolhoff, PHARM.D.
• Melissa Knorr, RN
• Stephanie Knowles, PT, DPT
• Cindy Knupp, SLPA
• William Eric Kobler, MD
• Laura Koch Loner, ANP

• Physical Therapist in Rockford, IL
• Providers in Rockford, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.