Active NPI
Lara Eiler, PT
- Physical Therapist
- Hazel Crest, IL
National Provider Identifier
1124664693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.023058
- Practice address
- 17800 Kedzie Ave
Hazel Crest, IL 60429-2029 - Phone
- (708) 213-3825
- Fax
- (708) 213-0132
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.023058 | IL | Primary |
Addresses
Primary practice location
17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Mailing address
14517 Lemont Rd
Homer Glen, IL 60491-7563
Phone (708) 417-2467
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070.023058 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1124664693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14517 LEMONT RD",
"city": "HOMER GLEN",
"state": "IL",
"postal_code": "604917563",
"telephone_number": "708-417-2467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17800 KEDZIE AVE",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604292029",
"telephone_number": "708-213-3825",
"fax_number": "708-213-0132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EILER",
"first_name": "LARA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.023058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazel Crest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.