Individual provider Active NPI

Paola Cruickshank, LMT

  • Massage Therapist
  • Plainfield, IL
National Provider Identifier
1376921643
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.016651 Issued in IL
Practice address
15412 S Route 59
118
Plainfield, IL 60544-1979
Phone
(815) 267-6177
Fax
(815) 782-7038
NPI assigned
May 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227.016651 IL Primary

Addresses

Primary practice location

15412 S Route 59
118
Plainfield, IL 60544-1979

Mailing address

15412 S Route 59
118
Plainfield, IL 60544-1979
Phone (815) 267-6177

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
227.016651ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1376921643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15412 S ROUTE 59",
            "address_2": "118",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605441979",
            "telephone_number": "815-267-6177",
            "fax_number": "815-782-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15412 S ROUTE 59",
            "address_2": "118",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605441979",
            "telephone_number": "815-267-6177",
            "fax_number": "815-782-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUICKSHANK",
        "first_name": "PAOLA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.016651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.