Active NPI
Kathleen Buckingham, ATC
- Athletic Trainer
- Evanston, IL
National Provider Identifier
1235570268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.003271
- Practice address
- 2255 Campus Drive
Evanston, IL 60208-3810 - Phone
- (847) 491-8864
- NPI assigned
- Jul 6, 2013
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.003271 | IL | Primary |
Addresses
Primary practice location
2255 Campus Drive
Evanston, IL 60208-3810
Mailing address
2255 Campus Drive
Evanston, IL 60208-0001
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 |
|---|---|---|---|
| 096.003271 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1235570268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2255 CAMPUS DRIVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602080001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2255 CAMPUS DRIVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602083810",
"telephone_number": "847-491-8864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKINGHAM",
"first_name": "KATHLEEN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-06",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.003271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.