Individual provider Active NPI

Renee Starr, LMT

  • Massage Therapist
  • Willow Springs, IL
National Provider Identifier
1639618564
Registry record updated Feb 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.010585 Issued in IL
Practice address
8695 Archer Ave
Unit #13
Willow Springs, IL 60480-1260
Phone
(708) 702-5056
NPI assigned
Feb 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227.010585 IL Primary

Addresses

Primary practice location

8695 Archer Ave
Unit #13
Willow Springs, IL 60480-1260

Mailing address

8695 Archer Ave
Unit #13
Willow Springs, IL 60480-1260
Phone (708) 702-5056

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
227.010585ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1486857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486857600000",
    "number": "1639618564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8695 ARCHER AVE",
            "address_2": "UNIT #13",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801260",
            "telephone_number": "708-702-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8695 ARCHER AVE",
            "address_2": "UNIT #13",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801260",
            "telephone_number": "708-702-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-12",
        "last_updated": "2017-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.010585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Springs, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.