Active NPI
Kim Maria Gregory, P.T.
- Physical Therapist
- Chicago, IL
National Provider Identifier
1639435118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070018879
- Practice address
- 4801 W Peterson Ave
Suite 606
Chicago, IL 60646-5713 - Phone
- (773) 777-9100
- Fax
- (773) 777-9101
- NPI assigned
- Apr 9, 2012
- Sex
- Female
- Sole proprietor
- No
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 | 070018879 | IL | Primary |
Addresses
Primary practice location
4801 W Peterson Ave
Suite 606
Chicago, IL 60646-5713
Mailing address
4452 N Ashland Ave
Apt 6F
Chicago, IL 60640-6964
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070018879 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333929600000",
"number": "1639435118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4452 N ASHLAND AVE",
"address_2": "APT 6F",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606406964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 W PETERSON AVE",
"address_2": "SUITE 606",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606465713",
"telephone_number": "773-777-9100",
"fax_number": "773-777-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "KIM",
"middle_name": "MARIA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-09",
"last_updated": "2012-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070018879",
"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 Apr 9, 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.