Jamieson T Credille, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Practice address

1513 Dekalb Ave
Sycamore, IL 60178-2703

Phone

(815) 758-0000

Fax

(815) 991-9484

NPI assigned

Aug 17, 2017

Last updated

Aug 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1467978882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 ABERDEEN CT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783175",
            "telephone_number": "815-991-2333",
            "fax_number": "815-748-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 DEKALB AVE",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601782703",
            "telephone_number": "815-758-0000",
            "fax_number": "815-991-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREDILLE",
        "first_name": "JAMIESON",
        "middle_name": "T",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENSE",
            "identifier": "070023046",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Cook, M.D.
• Kendra Schreck Coots, D.T.
• Jennifer Corzine, ALMFT
• James Wesley Coulter, PT
• Cpo Services, Inc. (Comprehensive Prosthetics and Orthotics)
• Starline Rose Crouch, M.A. CCC-SLP
• Mackenzie Crowell
• John Ward Crown, DMD
• Lisa D Crutcher, M.D.
• Elizabeth Jean Cunningham, LCSW

• Orthopedic Physical Therapist in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Orthopedic Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; 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.