Active NPI
Janeen Rochelle Bolden, PT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1710133103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.016602
- Practice address
- 345 E Superior St
Chicago, IL 60611-2654 - Phone
- (312) 238-1000
- NPI assigned
- Aug 18, 2008
- 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 | 070.016602 | IL | Primary |
Addresses
Primary practice location
345 E Superior St
Chicago, IL 60611-2654
Mailing address
8932 S Dante Ave
Chicago, IL 60619-7114
Phone (773) 731-6738
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.016602 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219017600000",
"number": "1710133103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8932 S DANTE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606197114",
"telephone_number": "773-731-6738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 E SUPERIOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112654",
"telephone_number": "312-238-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "JANEEN",
"middle_name": "ROCHELLE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-18",
"last_updated": "2008-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.016602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.