Active NPI
Kimberly Nelson, PT
- Physical Therapist
- Des Plaines, IL
National Provider Identifier
1245406206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-003549
- Practice address
- 200 Howard Ave
Ste 248
Des Plaines, IL 60018-5906 - Phone
- (847) 803-0774
- Fax
- (847) 803-0821
- NPI assigned
- Apr 30, 2008
- Last updated
- May 1, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 070-003549 | IL | Primary |
Addresses
Primary practice location
200 Howard Ave
Ste 248
Des Plaines, IL 60018-5906
Mailing address
896 Riding LN
Saint Charles, IL 60174-4716
Phone (630) 849-5336
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 |
|---|---|---|---|
| 070-003549 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1245406206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "896 RIDING LN",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601744716",
"telephone_number": "630-849-5336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HOWARD AVE",
"address_2": "STE 248",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600185906",
"telephone_number": "847-803-0774",
"fax_number": "847-803-0821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KIMBERLY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-30",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-003549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.