Active NPI
Jill Pohlman
- Athletic Trainer
- Dekalb, IL
National Provider Identifier
1316484041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096004337
- Practice address
- 1525 W Lincoln Hwy
Dekalb, IL 60115-3989 - Phone
- (815) 861-4566
- NPI assigned
- Jan 19, 2017
- Last updated
- Jan 19, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096004337 | IL | Primary |
Addresses
Primary practice location
1525 W Lincoln Hwy
Dekalb, IL 60115-3989
Mailing address
1525 W Lincoln Hwy
Dekalb, IL 60115-3989
Phone (815) 861-4566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 096004337 | Other | IL | ATHLETIC TRAINER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 096004337 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1316484041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 W LINCOLN HWY",
"city": "DEKALB",
"state": "IL",
"postal_code": "601153989",
"telephone_number": "815-861-4566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 W LINCOLN HWY",
"city": "DEKALB",
"state": "IL",
"postal_code": "601153989",
"telephone_number": "815-861-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POHLMAN",
"first_name": "JILL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-19",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096004337",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "096004337",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.