Individual provider Active NPI

Daniel Kunz, ATC

  • Athletic Trainer
  • Oak Forest, IL
National Provider Identifier
1356113047
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096003174 Issued in IL
Practice address
5120 Shadow Creek Dr Unit 7
Oak Forest, IL 60452-3881
Phone
(708) 278-8844
NPI assigned
Oct 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096003174 IL Primary

Addresses

Primary practice location

5120 Shadow Creek Dr Unit 7
Oak Forest, IL 60452-3881

Mailing address

5120 Shadow Creek Dr Unit 7
Oak Forest, IL 60452-3881

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
096003174ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1356113047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 SHADOW CREEK DR UNIT 7",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 SHADOW CREEK DR UNIT 7",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523881",
            "telephone_number": "708-278-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNZ",
        "first_name": "DANIEL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096003174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.