Individual provider Active NPI

Nicole Lora Schroeter, DPT

  • Pediatric Physical Therapist
  • Crystal Lake, IL
National Provider Identifier
1619056942
Registry record updated Mar 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
070.015325 Issued in IL
Practice address
1095 Pingree Rd
Crystal Lake, IL 60014-1725
Phone
(847) 458-8890
Fax
(847) 458-8889
NPI assigned
Nov 6, 2006
Last updated
Mar 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 070.015325 IL Primary

Addresses

Primary practice location

1095 Pingree Rd
Crystal Lake, IL 60014-1725

Mailing address

1 Walnut LN
Algonquin, IL 60102-3029
Phone (630) 917-4072

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
070.015325ILMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489795200000",
    "number": "1619056942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WALNUT LN",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601023029",
            "telephone_number": "630-917-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 PINGREE RD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141725",
            "telephone_number": "847-458-8890",
            "fax_number": "847-458-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROETER",
        "first_name": "NICOLE",
        "middle_name": "LORA",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2017-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": "070.015325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2017; 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.