Core Fitness and PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070008168 Issued in IL

Legal business name

CORE FITNESS AND PT

Practice address

6475 Joliet Rd
Suite C
La Grange Highlands, IL 60525-4647

Phone

(708) 469-7441

Fax

(708) 469-7661

NPI assigned

Aug 16, 2012

Organization subpart

No

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

Authorized official

Name

Diane Fidler

Title

Owner

Phone

(708) 469-7441

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1629326947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 JOLIET RD",
            "address_2": "SUITE C",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605254647",
            "telephone_number": "708-469-7441",
            "fax_number": "708-469-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 JOLIET RD",
            "address_2": "SUITE C",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605254647",
            "telephone_number": "708-469-7441",
            "fax_number": "708-469-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE FITNESS AND PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "FIDLER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-469-7441"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070008168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Chen, DO
• May T Chow, MD
• Isabelle Vanmoon Chu, MD
• Ann M. Clark, BCBA
• Jessica M. Connor
• Dermatology Associates of Lagrange SC
• Chirag Doshi, M.D.
• Christine B Doyle, MD, PH.D.
• Elizabeth Drumm
• Jayci Nicole Dubik, NP-C

• All providers in La Grange Highlands, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.