Active NPI
Patty J Anderson, PTA
- Physical Therapy Assistant
- Volo, IL
National Provider Identifier
1194022137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160002239
- Practice address
- 700 Harp Ave
Volo, IL 60073-5931 - Phone
- (847) 341-4653
- NPI assigned
- Feb 25, 2011
- 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 | 160002239 | IL | Primary |
Addresses
Primary practice location
700 Harp Ave
Volo, IL 60073-5931
Mailing address
700 Harp Ave
Volo, IL 60073-5931
Phone (847) 341-4653
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 |
|---|---|---|---|
| 160002239 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298592000000",
"number": "1194022137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 HARP AVE",
"city": "VOLO",
"state": "IL",
"postal_code": "600735931",
"telephone_number": "847-341-4653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 HARP AVE",
"city": "VOLO",
"state": "IL",
"postal_code": "600735931",
"telephone_number": "847-341-4653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "PATTY",
"middle_name": "J",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-25",
"last_updated": "2011-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160002239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Volo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.