NPIMap

Organization Active NPI

Kimberly Vincent

  • Physical Therapy Clinic/Center
  • Park Ridge, IL
National Provider Identifier
1366763765
Registry record updated Jun 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
070-010881 Issued in IL
Legal business name
KIMBERLY VINCENT
Practice address
1775 Dempster St
Park Ridge, IL 60068-1143
Phone
(847) 723-7500
NPI assigned
Jun 20, 2010
Last updated
Jun 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2010

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

Authorized official

Name
Mrs. Kimberly Sue Vincent, P.T.
Title
Physical Therapist
Phone
(847) 723-3876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 070-010881 IL Primary

Addresses

Primary practice location

1775 Dempster St
Park Ridge, IL 60068-1143

Mailing address

1632 Riverview Ave
Des Plaines, IL 60018-2263
Phone (847) 813-9459

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1276992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276992000000",
    "number": "1366763765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 RIVERVIEW AVE",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600182263",
            "telephone_number": "847-813-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY VINCENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-20",
        "last_updated": "2010-06-20",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "847-723-3876",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070-010881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.