Active NPI
Katherine Klocek
- Physical Therapy Assistant
- Kankakee, IL
National Provider Identifier
1639800683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0040659
- Practice address
- 1601 Butterfield TRL
Kankakee, IL 60901-2959 - Phone
- (815) 342-2507
- NPI assigned
- Jun 21, 2022
- 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 Therapy Assistant | 225200000X | 0040659 | IL | Primary |
Addresses
Primary practice location
1601 Butterfield TRL
Kankakee, IL 60901-2959
Mailing address
480 Plum Creek CT Apt 1
Bourbonnais, IL 60914-1582
Phone (815) 342-2508
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1639800683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 PLUM CREEK CT APT 1",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609141582",
"telephone_number": "815-342-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 BUTTERFIELD TRL",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012959",
"telephone_number": "815-342-2507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOCEK",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-21",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "0040659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.