Individual provider Active NPI

Dorothy Elizabeth Callister, PT

  • Physical Therapist
  • Kankakee, IL
National Provider Identifier
1356651988
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.003769 Issued in IL
Practice address
1601 Butterfield TRL
Kankakee, IL 60901-2959
Phone
(815) 936-6500
Fax
(815) 936-6502
NPI assigned
Oct 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.003769 IL Primary

Addresses

Primary practice location

1601 Butterfield TRL
Kankakee, IL 60901-2959

Mailing address

1601 Butterfield TRL
Kankakee, IL 60901-2959
Phone (815) 936-6500

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
070.003769ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1356651988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BUTTERFIELD TRL",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012959",
            "telephone_number": "815-936-6500",
            "fax_number": "815-936-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BUTTERFIELD TRL",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012959",
            "telephone_number": "815-936-6500",
            "fax_number": "815-936-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISTER",
        "first_name": "DOROTHY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.003769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.