Kristin Vazzana, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

70011583 Issued in IL

Practice address

520 East Boughton Road
Bolingbrook, IL 60440

Phone

(630) 783-2438

Fax

(630) 783-2589

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Accelerated Rehabilitation Centers, LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Roscoe, IL
  • NPI 1043604184
  NPD (past)
• Flexeon Rehabilitation of Orland Park South, LLC

  • Physical Therapy Clinic/Center
  • Orland Park, IL
  • NPI 1407150956
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1538253141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 EAST BOUGHTON ROAD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60440",
            "telephone_number": "630-783-2438",
            "fax_number": "630-783-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZZANA",
        "first_name": "KRISTIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70011583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "name@3won.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "520 East Boughton Road",
            "city": "Bolingbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christian Van, MD
• Clay Gordon Vanderwall, DDS
• Sonal Mahajan Varma, D.O
• David Varney, O.D.
• Cinthia Vazquez
• Catherine Velasco, PT
• Gloria Velino
• Velora Equipment LLC
• Sarada Vemareddy, MD
• Srilakshmi Vemareddy, M.D.

• Physical Therapist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.