Individual provider Active NPI

Stephanie Kaskavage, PT

  • Physical Medicine & Rehabilitation Physician
  • Freeport, IL
National Provider Identifier
1285875864
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
070016902 Issued in IL
Practice address
1010 Fairway Dr
Freeport, IL 61032-6600
Phone
(815) 599-6000
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 070016902 IL Primary

Addresses

Primary practice location

1010 Fairway Dr
Freeport, IL 61032-6600

Mailing address

421 W Exchange St
PO Box 268
Freeport, IL 61032-4008
Phone (815) 599-7958

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
070016902ILMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1285875864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W EXCHANGE ST",
            "address_2": "PO BOX 268",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324008",
            "telephone_number": "815-599-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 FAIRWAY DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326600",
            "telephone_number": "815-599-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASKAVAGE",
        "first_name": "STEPHANIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "070016902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.