Individual provider Active NPI

Susan Lynn Fierke, P.T. A.

  • Physical Therapy Assistant
  • Chicago, IL
National Provider Identifier
1609922756
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.000486 Issued in IL
Practice address
222 S. Riverside Plaza
Ste 830
Chicago, IL 60606
Phone
(866) 386-0773
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.000486 IL Primary

Addresses

Primary practice location

222 S. Riverside Plaza
Ste 830
Chicago, IL 60606

Mailing address

5332 Coneflower Dr
Naperville, IL 60564-5340
Phone (630) 904-6254

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160.000486ILMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Supplemental Health Care Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609922756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5332 CONEFLOWER DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645340",
            "telephone_number": "630-904-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S. RIVERSIDE PLAZA",
            "address_2": "STE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60606",
            "telephone_number": "866-386-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIERKE",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "P.T. A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.000486",
            "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 Jul 8, 2007; 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.