Jacklyn M Winters, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070017657 Issued in IL

Practice address

1337 Lily Cache LN
Bolingbrook, IL 60490-4600

Phone

(630) 226-5110

Fax

(630) 226-5120

NPI assigned

Feb 26, 2010

Last updated

Feb 26, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brady, P.C.

  dba Momentum PT

  • Physical Therapy Clinic/Center
  • Bolingbrook, IL
  • NPI 1598940827

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1578885901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12640 S ROUTE 59",
            "address_2": "UNIT 110",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855400",
            "telephone_number": "815-676-3905",
            "fax_number": "630-754-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 LILY CACHE LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604904600",
            "telephone_number": "630-226-5110",
            "fax_number": "630-226-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "JACKLYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017657",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070017657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khadeeja Williams
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• Shelly Wilson, PT
• Daniel Wind
• Wise Counsel for Mental Health
• Grace Withrow
• Cindy Sue Wojtas
• Laura Jean Wolfe, LCPC
• Womens Center for Health L P

• 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 Feb 26, 2010; 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.