Active NPI
Maura Kelly, DPT
- Physical Therapist
- Downers Grove, IL
National Provider Identifier
1386072783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070020238
- Practice address
- 5625 Durand Dr
Downers Grove, IL 60516-1049 - Phone
- (630) 607-4447
- NPI assigned
- Oct 22, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070020238 | IL | Primary |
Addresses
Primary practice location
5625 Durand Dr
Downers Grove, IL 60516-1049
Mailing address
5625 Durand Dr
Downers Grove, IL 60516-1049
Phone (630) 607-4447
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070020238 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1386072783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5625 DURAND DR",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605161049",
"telephone_number": "630-607-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5625 DURAND DR",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605161049",
"telephone_number": "630-607-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MAURA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-22",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070020238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.