Active NPI
Jenny Gocolay
- Physical Therapist
- Burbank, IL
National Provider Identifier
1629353685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.017529
- Practice address
- 5625 W 79TH St
Burbank, IL 60459-1349 - Phone
- (708) 576-8049
- NPI assigned
- Oct 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.017529 | IL | Primary |
Addresses
Primary practice location
5625 W 79TH St
Burbank, IL 60459-1349
Mailing address
8300 S 86TH Ave
406
Justice, IL 60458-1857
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.017529 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimum Therapy Services, Inc. | Physical Therapist | Past | Accepting new patients |
| Stroke Rehabilitation Inc. | Physical Therapist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Burbank, IL
- NPI 1962645390
Physical Therapist
-
- Physical Therapy Clinic/Center
- Burbank, IL
- NPI 1386887776
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1629353685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8300 S 86TH AVE",
"address_2": "406",
"city": "JUSTICE",
"state": "IL",
"postal_code": "604581857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5625 W 79TH ST",
"city": "BURBANK",
"state": "IL",
"postal_code": "604591349",
"telephone_number": "708-576-8049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOCOLAY",
"first_name": "JENNY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-20",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.017529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, IL
- Gerald Ward DDS PC (Burbank Family Dentistry)
- Ayyah Samir Ghouleh
- Eanara Ghouleh, LSW
- Khursheed Gir, M.D.
- Samantha L Glickman, M.S.
- Raye Grimes-Rowe
- Connie Lynn Grimmett
- Guardian Angel Caregivers Inc
- H&M Medical Services Inc (H&M Cardiology)
- H&M Medical Services Inc (Medelite Medical Center and Urgent Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.