Active NPI
Kaitlin Veronica Mick
- Physical Therapy Assistant
- Glenview, IL
National Provider Identifier
1174108153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1702
- Practice address
- 2600 Compass Rd
Glenview, IL 60026-8001 - Phone
- (877) 787-3430
- NPI assigned
- Mar 11, 2021
- 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 Therapy Assistant | 225200000X | 1702 | NE | Primary |
Addresses
Primary practice location
2600 Compass Rd
Glenview, IL 60026-8001
Mailing address
4905 N 113TH St
Omaha, NE 68164-2115
Phone (402) 209-3299
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 |
|---|---|---|---|
| 1702 | NE | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1174108153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4905 N 113TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681642115",
"telephone_number": "402-209-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 COMPASS RD",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268001",
"telephone_number": "877-787-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICK",
"first_name": "KAITLIN",
"middle_name": "VERONICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-11",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NE",
"license": "1702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
- Michele R Monteith D.D.S. LLC
- Michelle Dwyer Physical Therapy and Consulting
- Michelle Dwyer PT
- Maria Michele Michelotti, MD
- Steven Garrett Michols, DDS
- Susan H Middleton, MA CCC-SLP
- Linta Midhun, APN-CNP
- Midwest Behavioral Health LLC
- Midwest Palliative & Hospice Carecenter
- Midwest Palliative & Hospice Carecenter
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.