Active NPI
Adam Kagan, DPT
- Orthopedic Physical Therapist
- Channahon, IL
National Provider Identifier
1639804156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 070024173
- Practice address
- 25407 S Bell Rd Ste a
Channahon, IL 60410-5630 - Phone
- (312) 421-1016
- NPI assigned
- Jul 19, 2022
- Last updated
- Jul 19, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 070024173 | IL | Primary |
Addresses
Primary practice location
25407 S Bell Rd Ste a
Channahon, IL 60410-5630
Mailing address
2435 Dickens Dr
Aurora, IL 60503-5764
Phone (630) 450-5423
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 |
|---|---|---|---|
| 070024173 | IL | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marathon Health, LLC | Current | Accepting new patients | |
| Marathon Health, LLC | Current | Accepting new patients |
Locations
25407 S Bell Rd
Ste A
Channahon, IL 60410
Phone (312) 421-1016
Interoperability endpoints
- adam.kagan.1@14940.direct.athenahealth.com
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658188800000",
"number": "1639804156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2435 DICKENS DR",
"city": "AURORA",
"state": "IL",
"postal_code": "605035764",
"telephone_number": "630-450-5423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25407 S BELL RD STE A",
"city": "CHANNAHON",
"state": "IL",
"postal_code": "604105630",
"telephone_number": "312-421-1016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAGAN",
"first_name": "ADAM",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-19",
"last_updated": "2022-07-19",
"certification_date": "2022-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "IL",
"license": "070024173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Channahon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.