Active NPI
Elizabeth Antosz
- Athletic Trainer
- Glendale Heights, IL
National Provider Identifier
1508305327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 20000017381
- Practice address
- 2234 Lake Ridge Drive
Glendale Heights, IL 60139 - Phone
- (224) 636-1992
- NPI assigned
- Feb 13, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | E3297785 | CA | |
| Athletic Trainer | 2255A2300X | 20000017381 | IL | Primary |
Addresses
Primary practice location
2234 Lake Ridge Drive
Glendale Heights, IL 60139
Mailing address
3899 Nobel Drive
1421
San Diego, CA 92122
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 |
|---|---|---|---|
| E3297785 | CA | MD | Basic Emergency Medical Technician |
| 20000017381 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1508305327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3899 NOBEL DRIVE",
"address_2": "1421",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2234 LAKE RIDGE DRIVE",
"city": "GLENDALE HEIGHTS",
"state": "IL",
"postal_code": "60139",
"telephone_number": "224-636-1992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOSZ",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-13",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "CA",
"license": "E3297785",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "20000017381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.