Katie E. Allen-Wacker, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160005283 Issued in IL

Practice address

212 Lindow Lane
Suite M
Marengo, IL 60152

Phone

(815) 568-8878

Fax

(815) 568-9977

NPI assigned

Nov 10, 2009

Last updated

Nov 10, 2009By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1609103787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1534",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081705",
            "telephone_number": "815-568-8878",
            "fax_number": "815-568-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 LINDOW LANE",
            "address_2": "SUITE M",
            "city": "MARENGO",
            "state": "IL",
            "postal_code": "60152",
            "telephone_number": "815-568-8878",
            "fax_number": "815-568-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN-WACKER",
        "first_name": "KATIE",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160005283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Accelerated Rehabilitation Center of Kenosha LTD
• Accelerated Rehabilitation Centers of Kenosha LTD (Athletico Physical Therapy)
• Tanveer Ahmad, MD
• Jordan Andrews
• Bankord Chiropractic, PLLC
• Jace Bankord, DC
• Luke Bankord, BA, DC
• Matthew W Bankord, DC

• Physical Therapy Assistant in Marengo, IL
• Providers in Marengo, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.