Active NPI
Pamela Travers, PT
- Physical Therapist
- Streator, IL
National Provider Identifier
1255489696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-007993
- Practice address
- 205 S Park St
Streator, IL 61364-4448 - Phone
- (815) 673-1770
- Fax
- (815) 673-1772
- NPI assigned
- Jan 8, 2007
- 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 | 070-007993 | IL | Primary |
Addresses
Primary practice location
205 S Park St
Streator, IL 61364-4448
Mailing address
205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216
Phone (312) 640-0329
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-007993 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376611200000",
"number": "1255489696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 W WACKER DR",
"address_2": "SUITE 1020",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606061216",
"telephone_number": "312-640-0329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S PARK ST",
"city": "STREATOR",
"state": "IL",
"postal_code": "613644448",
"telephone_number": "815-673-1770",
"fax_number": "815-673-1772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVERS",
"first_name": "PAMELA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2013-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-007993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Streator, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.