NPIMap

Individual provider Active NPI

Sharon Anderson, PT

  • Physical Therapist
  • Countryside, IL
National Provider Identifier
1578717005
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070 003313 Issued in IL
Practice address
100 W Plainfield Rd
Countryside, IL 60525-2869
Phone
(708) 588-0833
Fax
(708) 588-0406
NPI assigned
Nov 11, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
070 003313ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Independence Through Conductive Education Inc Physical Therapist Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070 003313 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

100 W Plainfield Rd
Countryside, IL 60525-2869

Mailing address

100 W Plainfield Rd
Countryside, IL 60525-2869
Phone (708) 588-0833

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 11, 2008.

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1578717005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W PLAINFIELD RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605252869",
            "telephone_number": "708-588-0833",
            "fax_number": "708-588-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W PLAINFIELD RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605252869",
            "telephone_number": "708-588-0833",
            "fax_number": "708-588-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHARON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070 003313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Countryside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.