Active NPI
Karen Leanne Nicol, P.T.
- Physical Therapist
- Evergreen Park, IL
National Provider Identifier
1225432479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070008556
- Practice address
- 3849 W 95TH St
Evergreen Park, IL 60805-2020 - Phone
- (708) 229-9828
- Fax
- (708) 422-0914
- NPI assigned
- Oct 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070008556 | IL | Primary |
Addresses
Primary practice location
3849 W 95TH St
Evergreen Park, IL 60805-2020
Mailing address
3849 W 95TH St
Evergreen Park, IL 60805-2020
Phone (708) 229-9828
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070008556 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Occupational Therapy Providers Inc. | Physical Therapist | Past | Accepting new patients |
| Therapy Services LTD | Physical Therapist | Past | Accepting new patients |
| Therapy Providers of America Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Physical Therapist
- Evergreen Park, IL
- NPI 1891836664
-
- Physical Therapist
- Oak Lawn, IL
- NPI 1447396270
-
dba Physical Therapy Associates Ltd
- Physical Therapist
- Berwyn, IL
- NPI 1588705800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1225432479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3849 W 95TH ST",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052020",
"telephone_number": "708-229-9828",
"fax_number": "708-422-0914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3849 W 95TH ST",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052020",
"telephone_number": "708-229-9828",
"fax_number": "708-422-0914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOL",
"first_name": "KAREN",
"middle_name": "LEANNE",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-17",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070008556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evergreen Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.