Jay Patrick Anderson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

96000601 Issued in IL

Practice address

1151 N State St
Elgin, IL 60123-1404

Phone

(847) 628-1592

Fax

(847) 628-1591

NPI assigned

Nov 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1306828645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 CORRINE AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600145161",
            "telephone_number": "815-356-0456",
            "fax_number": "847-628-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601231404",
            "telephone_number": "847-628-1592",
            "fax_number": "847-628-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JAY",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "96000601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noor Amer Anbaki
• Anchorcare Health PLLC
• Alison Paige Anderson, RN
• Carrie R Anderson, PA-C
• Henry Anderson, BS
• Julie Jelaine Anderson, D.O.
• Mari A. Anderson, C.R.N.F.A.
• Andresen Active Healthcare, P.C.
• Craig A. Andresen, DC
• Alyssa Rae Andrews

• All providers in Elgin, IL
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.