Active NPI
Jennifer Ann Tymkew, ATC
- Athletic Trainer
- Evanston, IL
National Provider Identifier
1255398160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096-002001
- Practice address
- 1501 Central St
Evanston, IL 60208-0840 - Phone
- (847) 491-8863
- NPI assigned
- Apr 26, 2006
- 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 | 096-002001 | IL | Primary |
Addresses
Primary practice location
1501 Central St
Evanston, IL 60208-0840
Mailing address
2133 Central St
#3
Evanston, IL 60201-5824
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 |
|---|---|---|---|
| 096-002001 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1255398160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2133 CENTRAL ST",
"address_2": "#3",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602015824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 CENTRAL ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602080840",
"telephone_number": "847-491-8863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYMKEW",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-26",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096-002001",
"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 Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.