Kathleen A Clark, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070011591 Issued in IL

Practice address

2700 Keslinger Road
Suite C
Geneva, IL 60134-4645

Phone

(630) 262-2633

Fax

(630) 262-2643

NPI assigned

Aug 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen A. Witte Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Attentive Individualized Management Physical Therapy, LLCGroup PAC ID 5395091581, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Attentive Individualized Management Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Sugar Grove, IL
  • NPI 1497244859
  Medicare reassignment Care Compare group
• Elmhurst Orthopaedics, SC

  • Orthopaedic Surgery Physician
  • Elmhurst, IL
  • NPI 1598716474
  NPD (past)
• Orthopedic Associates of Naperville SC

  • Specialist
  • Naperville, IL
  • NPI 1699892794
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1174515829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 274",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605545031",
            "telephone_number": "630-466-9240",
            "fax_number": "630-466-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 KESLINGER ROAD",
            "address_2": "SUITE C",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344645",
            "telephone_number": "630-262-2633",
            "fax_number": "630-262-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "WITTE",
            "middle_name": "A.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Marie Cibura, LCSW
• Peter D Cladis, M.D.
• Alythea Claiborne, RBT
• Christine M Clark, PT
• Jessica J Clark, PA C
• Michelle J Clark, NPP,LPC,LCPC
• Clear Mountain Therapy LLC
• Clear Path Counseling, PLLC
• Steven Coker, M.D.
• Carson Collins, RBT

• Physical Therapist in Geneva, IL
• Providers in Geneva, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.