Active NPI
Lesgreen Gammad Babaran, PT
- Physical Therapist
- Itasca, IL
National Provider Identifier
1699007898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.017468
- Practice address
- 650 E Devon Ave
Suite 190
Itasca, IL 60143-1251 - Phone
- (630) 379-8784
- NPI assigned
- Feb 12, 2010
- Last updated
- Feb 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 070.017468 | IL | Primary |
Addresses
Primary practice location
650 E Devon Ave
Suite 190
Itasca, IL 60143-1251
Mailing address
3201 W Commercial Blvd
Suite 116
Fort Lauderdale, FL 33309-3440
Phone (800) 886-8108
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 |
|---|---|---|---|
| 070.017468 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medpro | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Fort Lauderdale, FL
- NPI 1033353339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265932800000",
"number": "1699007898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 W COMMERCIAL BLVD",
"address_2": "SUITE 116",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333093440",
"telephone_number": "800-886-8108",
"fax_number": "866-422-6431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E DEVON AVE",
"address_2": "SUITE 190",
"city": "ITASCA",
"state": "IL",
"postal_code": "601431251",
"telephone_number": "630-379-8784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BABARAN",
"first_name": "LESGREEN",
"middle_name": "GAMMAD",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-12",
"last_updated": "2010-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.017468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Itasca, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.