Kelli Clevenger, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-014451 Issued in IL

Practice address

3497 Gallant Fox Dr
Elgin, IL 60124-5701

Phone

(847) 345-2677

NPI assigned

Feb 27, 2020

Sex

Female

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

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fox Rehabilitation Services Il LLC

  • Physical Therapist
  • Westchester, IL
  • NPI 1114443462
  Medicare reassignment NPD

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1356975353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3497 GALLANT FOX DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601245701",
            "telephone_number": "847-345-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3497 GALLANT FOX DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601245701",
            "telephone_number": "847-345-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "KELLI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Elgin
• Clarity of Mind Counseling, Inc.
• Clarity, Calm & Peace Behavioral Health Services, Inc.
• Kimberly Nicole Clark, MMS, PA-C
• Jasmoniqua Cleveland
• Patricia Cline, LCSW
• Beth A Clingan, DO
• Clinica Su Red Elgin LLC
• Jane S Cobler, DPT
• Emma Cohen, MSW

• Physical Therapist in Elgin, IL
• Providers in Elgin, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.