Individual provider Active NPI

Katelyn Sue Benning, ATC/L

  • Athletic Trainer
  • Glenview, IL
National Provider Identifier
1679769368
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
1500 Waukegan Rd
Suite 250
Glenview, IL 60025-2100
Phone
(847) 657-9445
NPI assigned
Sep 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X IL Primary

Addresses

Primary practice location

1500 Waukegan Rd
Suite 250
Glenview, IL 60025-2100

Mailing address

1500 Waukegan Rd
Suite 250
Glenview, IL 60025-2100
Phone (847) 657-9445

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
096.002434ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1679769368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WAUKEGAN RD",
            "address_2": "SUITE 250",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252100",
            "telephone_number": "847-657-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WAUKEGAN RD",
            "address_2": "SUITE 250",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252100",
            "telephone_number": "847-657-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNING",
        "first_name": "KATELYN",
        "middle_name": "SUE",
        "credential": "ATC/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; 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.