Active NPI
Jean A Kestner, PT
- Physical Therapist
- Peoria, IL
National Provider Identifier
1154761401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.002261
- Practice address
- 112 NE Madison Ave
Peoria, IL 61602-1109 - Phone
- (309) 674-7874
- NPI assigned
- Jul 1, 2013
- 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 | 070.002261 | IL | Primary |
Addresses
Primary practice location
112 NE Madison Ave
Peoria, IL 61602-1109
Mailing address
3619 Eagle BND
Pekin, IL 61554-7410
Phone (309) 840-1903
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 |
|---|---|---|---|
| 070.002261 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372636800000",
"number": "1154761401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3619 EAGLE BND",
"city": "PEKIN",
"state": "IL",
"postal_code": "615547410",
"telephone_number": "309-840-1903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 NE MADISON AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021109",
"telephone_number": "309-674-7874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KESTNER",
"first_name": "JEAN",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-01",
"last_updated": "2013-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.002261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.