Ellis Pediatric Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070008366 Issued in IL

Legal business name

ELLIS PEDIATRIC PHYSICAL THERAPY

Practice address

310 Happ Rd Ste 310
Northfield, IL 60093-3455

Phone

(847) 602-5016

NPI assigned

Apr 25, 2016

Organization subpart

No

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

Authorized official

Name

Juliette Ellis, P.T.NPI 1780879908

Title

Physical Therapist

Phone

(847) 602-5016

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Juliette Rachel Ellis, P.T.

  • Pediatric Physical Therapist
  • Glencoe, IL
  • NPI 1780879908
  NPD (past) Authorized official

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1265887491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 OAKDALE AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600222112",
            "telephone_number": "847-602-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HAPP RD STE 310",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933455",
            "telephone_number": "847-602-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS PEDIATRIC PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JULIETTE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "847-602-5016",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070008366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Northfield, IL
• Providers in Northfield, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.