Active NPI
Amy Brault
- Athletic Trainer
- Palatine, IL
National Provider Identifier
1700937281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1111 N Rohlwing Rd
Palatine, IL 60074-3777 - Phone
- (847) 755-1790
- NPI assigned
- Jan 13, 2007
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | IL | Primary |
Addresses
Primary practice location
1111 N Rohlwing Rd
Palatine, IL 60074-3777
Mailing address
3 Lakebreeze CT
Lake Zurich, IL 60047-2243
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 |
|---|---|---|---|
| 096001064 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700937281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 LAKEBREEZE CT",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "600472243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 N ROHLWING RD",
"city": "PALATINE",
"state": "IL",
"postal_code": "600743777",
"telephone_number": "847-755-1790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAULT",
"first_name": "AMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatine, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.