Individual provider Active NPI

Brenda Valdez

  • Physical Therapy Assistant
  • Cicero, IL
National Provider Identifier
1346873452
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160008684 Issued in IL
Practice address
1926 S 61St Ave # 2
Cicero, IL 60804-1648
Phone
(708) 427-5345
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160008684 IL Primary

Addresses

Primary practice location

1926 S 61St Ave # 2
Cicero, IL 60804-1648

Mailing address

1926 S 61St Ave # 2
Cicero, IL 60804-1648
Phone (708) 427-5345

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL laptop

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
160008684ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1346873452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 S 61ST AVE # 2",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041648",
            "telephone_number": "708-427-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 S 61ST AVE # 2",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041648",
            "telephone_number": "708-427-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "BRENDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160008684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "address_1": "1926 S 61st Ave # 2",
            "city": "Cicero",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608041648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.