Individual provider Active NPI

Christine Skibicki, ATC/L

  • Athletic Trainer
  • Minooka, IL
National Provider Identifier
1700283637
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096.003897 Issued in IL
Practice address
608 Chestnut RDG
Minooka, IL 60447-9259
Phone
(630) 770-8101
NPI assigned
Nov 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096.003897 IL Primary

Addresses

Primary practice location

608 Chestnut RDG
Minooka, IL 60447-9259

Mailing address

608 Chestnut RDG
Minooka, IL 60447-9259
Phone (630) 770-8101

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
096.003897ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1700283637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 CHESTNUT RDG",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479259",
            "telephone_number": "630-770-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 CHESTNUT RDG",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479259",
            "telephone_number": "630-770-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIBICKI",
        "first_name": "CHRISTINE",
        "credential": "ATC/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.003897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minooka, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.