Kim M Sheehan, PTA

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

1600011401 Issued in IL

Practice address

5201 Walnut Avenue
Ste 4
Downers Grove, IL 60515-4025

Phone

(630) 964-4707

Fax

(630) 964-4797

NPI assigned

Jan 17, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Pediatric Rehabilitation Services

  • Rehabilitation Clinic/Center
  • Downers Grove, IL
  • NPI 1639221682
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205988334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WALNUT AVENUE",
            "address_2": "STE 4",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154025",
            "telephone_number": "630-964-4707",
            "fax_number": "630-964-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WALNUT AVENUE",
            "address_2": "STE 4",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154025",
            "telephone_number": "630-964-4707",
            "fax_number": "630-964-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "KIM",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": "1600011401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arjun Sharma
• Sharon Boris, LCSW LLC
• Jennifer Ann Shea, LCSW, MSW
• Karen S Sheehan, SPEECH THERAPIST
• Kerry V Sheehan, D.O.
• Elizabeth Shelus, O.D.
• Tsungyao Robert Sheng, D.C.
• Sherif Albert DDS, PC
• Shannon K Sherman
• Jamie Alyssa Shifley, RDN

• Pediatric Physical Therapist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Pediatric Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.