Individual provider Active NPI

Karen Phagan, P.T.

  • Physical Medicine & Rehabilitation Physician
  • Vernon Hills, IL
National Provider Identifier
1235363078
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
070005240 Issued in IL
Practice address
555 Corporate Woods Pkwy
Vernon Hills, IL 60061-3111
Phone
(847) 634-9400
Fax
(847) 634-2900
NPI assigned
May 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 070005240 IL Primary

Addresses

Primary practice location

555 Corporate Woods Pkwy
Vernon Hills, IL 60061-3111

Mailing address

555 Corporate Woods Pkwy
Vernon Hills, IL 60061-3111
Phone (847) 634-9400

Other identifiers 1

IdentifierTypeStateIssuer
070005240OtherILLICENSE NO PHYSICAL THERAPIST

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
070005240ILMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1235363078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CORPORATE WOODS PKWY",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600613111",
            "telephone_number": "847-634-9400",
            "fax_number": "847-634-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CORPORATE WOODS PKWY",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600613111",
            "telephone_number": "847-634-9400",
            "fax_number": "847-634-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAGAN",
        "first_name": "KAREN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "070005240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO PHYSICAL THERAPIST",
            "identifier": "070005240",
            "state": "IL"
        }
    ],
    "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 May 7, 2009; 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.