Carly Harris, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013085 Issued in IL

Practice address

600 W Van Buren St
#106
Chicago, IL 60607-3708

Phone

(312) 361-3449

NPI assigned

Jan 18, 2007

Last updated

Dec 11, 2012By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 360 Physical Therapy, LLC

  • Physical Therapist
  • Chicago, IL
  • NPI 1154651149
  NPD (past)
• Millenium Park Medical Center, SC

  • Chiropractor
  • Chicago, IL
  • NPI 1942538145

  Physical Therapist

  NPD (past)
• Rosenthal Clinic SC

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1942306758
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1215080999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W VAN BUREN ST",
            "address_2": "#106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073708",
            "telephone_number": "312-361-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W VAN BUREN ST",
            "address_2": "#106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073708",
            "telephone_number": "312-361-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CARLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "070013085",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashton Harris, APRN, CNP
• Bhrandon Harris, M.D.
• Bianca Harris
• Brea Rebecca Harris, WHNP-BC
• Bria Harris, LPC
• Casey Alyson Harris, PH.D.
• Catherine Adelia Harris, LCSW
• Charles Harris, M.D.
• Chiwana Harris
• Christa J Harris, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.