Individual provider Active NPI

Kathryn T Sheehan

  • Physical Therapist
  • Park Ridge, IL
National Provider Identifier
1255641007
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.003228 Issued in IL
Practice address
1530 Potter Rd
Park Ridge, IL 60068-1406
Phone
(847) 698-4447
NPI assigned
Oct 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.003228 IL Primary

Addresses

Primary practice location

1530 Potter Rd
Park Ridge, IL 60068-1406

Mailing address

1530 Potter Rd
Park Ridge, IL 60068-1406
Phone (847) 698-4447

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
070.003228ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1255641007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 POTTER RD",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681406",
            "telephone_number": "847-698-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 POTTER RD",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681406",
            "telephone_number": "847-698-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "KATHRYN",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.003228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.