Active NPI
Henry Fajardo
- Physical Therapist
- Northfield, IL
National Provider Identifier
1306124284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 550 W Frontage Rd Ste 2415
Northfield, IL 60093-1212 - Phone
- (877) 787-3422
- NPI assigned
- Jul 27, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 070014005 | IL | |
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
550 W Frontage Rd Ste 2415
Northfield, IL 60093-1212
Mailing address
550 Frontage Rd Ste 2415
Northfield, IL 60093
Phone (877) 787-3422
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382659200000",
"number": "1306124284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 FRONTAGE RD STE 2415",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "60093",
"telephone_number": "877-787-3422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 W FRONTAGE RD STE 2415",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "600931212",
"telephone_number": "877-787-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAJARDO",
"first_name": "HENRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-27",
"last_updated": "2013-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "IL",
"license": "070014005",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.