Individual provider Active NPI

Kailey Becker, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1598349052
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.025332 Issued in IL
Practice address
1103 S State St Ste 300
Chicago, IL 60605-2775
Phone
(312) 877-5101
Fax
(312) 877-5906
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.025332 IL Primary

Addresses

Primary practice location

1103 S State St Ste 300
Chicago, IL 60605-2775

Mailing address

24014 W Renwick Rd Ste F
Plainfield, IL 60544-8708
Phone (800) 974-4378

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Mar 3, 2024 Accepting new patients
DPT Holdings PLLC PastSince May 1, 2021 Accepting new patients

Locations

602 S Neil St
Champaign, IL 61820
Phone (217) 649-0504

1103 S State St
Ste 300
Chicago, IL 60605
Phone (312) 877-5101

15441 S 94th Ave
Orland Park, IL 60462
Phone (708) 981-3715

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1598349052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD STE F",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448708",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 S STATE ST STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052775",
            "telephone_number": "312-877-5101",
            "fax_number": "312-877-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "KAILEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.