Individual provider Active NPI

Kathleen Alys Giuffre

  • Developmental Therapist
  • Palos Park, IL
National Provider Identifier
1205149085
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
2460643 Issued in IL
Practice address
19 Birchwood Dr
Palos Park, IL 60464-1574
Phone
(708) 448-2851
NPI assigned
Jul 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 2460643 IL Primary

Addresses

Primary practice location

19 Birchwood Dr
Palos Park, IL 60464-1574

Mailing address

19 Birchwood Dr
Palos Park, IL 60464-1574
Phone (708) 448-2851

Other names 1

  • Miss Kathleen Alys Conway Former name

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
2460643ILMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1205149085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BIRCHWOOD DR",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641574",
            "telephone_number": "708-448-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BIRCHWOOD DR",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641574",
            "telephone_number": "708-448-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIUFFRE",
        "first_name": "KATHLEEN",
        "middle_name": "ALYS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "2460643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "CONWAY",
            "middle_name": "ALYS",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palos Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.

Verify at the official NPI Registry.