Individual provider Active NPI

James V Stepanich, ATC

  • Athletic Trainer
  • Oak Brook, IL
National Provider Identifier
1225006356
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096-000862 Issued in IL
Practice address
1420 Kensington Rd
Suite 106
Oak Brook, IL 60523-2143
Phone
(630) 449-4638
Fax
(630) 449-4638
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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 096-000862 IL Primary

Addresses

Primary practice location

1420 Kensington Rd
Suite 106
Oak Brook, IL 60523-2143

Mailing address

15W706 Lexington St
Elmhurst, IL 60126-5140
Phone (630) 279-9501

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
096-000862ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1225006356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15W706 LEXINGTON ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265140",
            "telephone_number": "630-279-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 KENSINGTON RD",
            "address_2": "SUITE 106",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232143",
            "telephone_number": "630-449-4638",
            "fax_number": "630-449-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANICH",
        "first_name": "JAMES",
        "middle_name": "V",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096-000862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.