Individual provider Active NPI

Kelsey Ulliman, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1447722269
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.024119 Issued in IL
Practice address
2569 W Fullerton Ave
Chicago, IL 60647-3147
Phone
(773) 252-4921
NPI assigned
Dec 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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 070.024119 IL Primary

Addresses

Primary practice location

2569 W Fullerton Ave
Chicago, IL 60647-3147

Mailing address

2569 W Fullerton Ave
Chicago, IL 60647-3147
Phone (773) 252-4921

Other practice location 1

1151 S State St
Chicago, IL 60605-2304
Phone (312) 583-1220

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
070.024119ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1447722269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2569 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473147",
            "telephone_number": "773-252-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2569 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473147",
            "telephone_number": "773-252-4921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 S State St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606052304",
            "country_code": "US",
            "telephone_number": "312-583-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULLIMAN",
        "first_name": "KELSEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.024119",
            "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 Dec 18, 2018; 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.