Individual provider Active NPI

Katherine Dusell, ATC

  • Athletic Trainer
  • Aurora, IL
National Provider Identifier
1164801122
Registry record updated May 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096.003158 Issued in IL
Practice address
849 Hearthstone CT
Aurora, IL 60506-1952
Phone
(630) 303-8887
NPI assigned
May 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096.003158 IL Primary

Addresses

Primary practice location

849 Hearthstone CT
Aurora, IL 60506-1952

Mailing address

849 Hearthstone CT
Aurora, IL 60506-1952
Phone (630) 303-8887

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

LicenseStateTypeSpecialty
096.003158ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1432339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432339200000",
    "number": "1164801122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 HEARTHSTONE CT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061952",
            "telephone_number": "630-303-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 HEARTHSTONE CT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061952",
            "telephone_number": "630-303-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSELL",
        "first_name": "KATHERINE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-23",
        "last_updated": "2015-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.003158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2015; 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.