Individual provider Active NPI

Kaiisha Dear Sweet

  • Prosthetist
  • Evergreen Park, IL
National Provider Identifier
1124586078
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Practice address
3408 W 95TH St
Evergreen Park, IL 60805-2204
Phone
(312) 504-1253
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthetistGroup: 193400000X SINGLE SPECIALTY GROUP 224P00000X IL Primary

Addresses

Primary practice location

3408 W 95TH St
Evergreen Park, IL 60805-2204

Mailing address

11302 S Union Ave
Chicago, IL 60628-4726

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

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1124586078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11302 S UNION AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052204",
            "telephone_number": "312-504-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAR SWEET",
        "first_name": "KAIISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.