Individual provider Active NPI

Joseph Payawal, ATC/L

  • Athletic Trainer
  • Vernon Hills, IL
National Provider Identifier
1215334206
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096002510 Issued in IL
Practice address
145 Lakeview Pkwy
Vernon Hills, IL 60061-1566
Phone
(847) 932-2025
NPI assigned
Nov 19, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096002510 IL Primary

Addresses

Primary practice location

145 Lakeview Pkwy
Vernon Hills, IL 60061-1566

Mailing address

145 Lakeview Pkwy
Vernon Hills, IL 60061-1566
Phone (847) 932-2025

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
096002510ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1215334206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 LAKEVIEW PKWY",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611566",
            "telephone_number": "847-932-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 LAKEVIEW PKWY",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611566",
            "telephone_number": "847-932-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYAWAL",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "ATC/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.