Active NPI
Eileen Diane Caadan Chavez, PT
- Physical Therapist
- Countryside, IL
National Provider Identifier
1639708142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070022710
- Practice address
- 6170 Joliet Rd # I
Countryside, IL 60525-3976 - Phone
- (708) 352-0330
- NPI assigned
- Apr 6, 2020
- 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 | 070022710 | IL | Primary |
Addresses
Primary practice location
6170 Joliet Rd # I
Countryside, IL 60525-3976
Mailing address
2241 Desplaines Ave Apt 4
North Riverside, IL 60546-1291
Phone (224) 325-6622
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 |
|---|---|---|---|
| 070022710 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586131200000",
"number": "1639708142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2241 DESPLAINES AVE APT 4",
"city": "NORTH RIVERSIDE",
"state": "IL",
"postal_code": "605461291",
"telephone_number": "224-325-6622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6170 JOLIET RD # I",
"city": "COUNTRYSIDE",
"state": "IL",
"postal_code": "605253976",
"telephone_number": "708-352-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "EILEEN DIANE",
"middle_name": "CAADAN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-06",
"last_updated": "2020-04-06",
"certification_date": "2020-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070022710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Countryside, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.