Active NPI
Anne Haseman, PT
- Physical Therapist
- Crystal Lake, IL
National Provider Identifier
1700988250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-004170
- Practice address
- 95 S McHenry Ave
Crystal Lake, IL 60014-6043 - Phone
- (815) 353-2411
- Fax
- (224) 333-6710
- NPI assigned
- Sep 4, 2006
- 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 | 070-004170 | IL | Primary |
Addresses
Primary practice location
95 S McHenry Ave
Crystal Lake, IL 60014-6043
Mailing address
PO Box 1723
Crystal Lake, IL 60039-1723
Phone (815) 356-7680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005683004 | Other | IL | BLUE CROSS/BLUE SHIELD |
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 |
|---|---|---|---|
| 070-004170 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510099200000",
"number": "1700988250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1723",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600391723",
"telephone_number": "815-356-7680",
"fax_number": "815-356-7864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 S MCHENRY AVE",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600146043",
"telephone_number": "815-353-2411",
"fax_number": "224-333-6710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASEMAN",
"first_name": "ANNE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-04",
"last_updated": "2017-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-004170",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "0005683004",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.