Individual provider Active NPI

Kelly Dunn, PT

  • Physical Therapist
  • Tinley Park, IL
National Provider Identifier
1285901876
Registry record updated Nov 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070018841 Issued in IL
Practice address
18425 W Creek Dr Ste B
Tinley Park, IL 60477-6768
Phone
(708) 532-1337
Fax
(708) 532-1899
NPI assigned
Nov 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2011

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 070018841 IL Primary

Addresses

Primary practice location

18425 W Creek Dr Ste B
Tinley Park, IL 60477-6768

Mailing address

321 S Sangamon St
Chicago, IL 60607-3586
Phone (708) 532-1337

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
070018841ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1322265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322265600000",
    "number": "1285901876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S SANGAMON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073586",
            "telephone_number": "708-532-1337",
            "fax_number": "708-532-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 W CREEK DR STE B",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776768",
            "telephone_number": "708-532-1337",
            "fax_number": "708-532-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "KELLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-26",
        "last_updated": "2011-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.

Verify at the official NPI Registry.