Individual provider Active NPI

Katie Lissette Velazquez, PT, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1396578290
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070028532 Issued in IL
Practice address
1420 W 18TH St
Chicago, IL 60608-3004
Phone
(773) 830-2270
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 070028532 IL Primary

Addresses

Primary practice location

1420 W 18TH St
Chicago, IL 60608-3004

Mailing address

1839 Gunderson Ave Apt 2
Berwyn, IL 60402-1460
Phone (773) 209-9388

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
070028532ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rci (WRS), LLC. Physical Therapist Current Accepting new patients
Rci (WRS), LLC. CurrentSince Sep 9, 2024 Accepting new patients
Rci (WRS), LLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

1420 W 18th St
Chicago, IL 60608
Phone (773) 830-2270

826 W Touhy Ave
Park Ridge, IL 60068
Phone (847) 720-4165

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1396578290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 GUNDERSON AVE APT 2",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021460",
            "telephone_number": "773-209-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W 18TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083004",
            "telephone_number": "773-830-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "KATIE",
        "middle_name": "LISSETTE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.