Active NPI
Amy L Stephens, PTA
- Physical Therapy Assistant
- Clarendon Hills, IL
National Provider Identifier
1407518632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160.007647
- Practice address
- 215 55TH St
Clarendon Hills, IL 60514-1578 - Phone
- (630) 468-2776
- NPI assigned
- Oct 5, 2021
- 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 Therapy Assistant | 225200000X | 160.007647 | IL | Primary |
Addresses
Primary practice location
215 55TH St
Clarendon Hills, IL 60514-1578
Mailing address
153 Tanoak LN
Naperville, IL 60540-7919
Phone (630) 428-9098
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 |
|---|---|---|---|
| 160.007647 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633392000000",
"number": "1407518632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 TANOAK LN",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605407919",
"telephone_number": "630-428-9098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 55TH ST",
"city": "CLARENDON HILLS",
"state": "IL",
"postal_code": "605141578",
"telephone_number": "630-468-2776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "AMY",
"middle_name": "L",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-05",
"last_updated": "2021-10-05",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.007647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarendon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.