Individual provider Active NPI

Nicole Grace Yule, DPT

  • Physical Therapist
  • Burr Ridge, IL
National Provider Identifier
1710335237
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016282 Issued in OH
Practice address
7055 High Grove Blvd
Burr Ridge, IL 60527-7628
Phone
(630) 371-1623
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016282 OH Primary

Addresses

Primary practice location

7055 High Grove Blvd
Burr Ridge, IL 60527-7628

Mailing address

7055 High Grove Blvd
Burr Ridge, IL 60527-7628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231017002188 WI Practitioner - Physical Therapist in Private Practice 7719272608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT016282OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Sep 20, 2023 Accepting new patients
Ngy LLC Physical Therapist Current Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Sep 20, 2023 Accepting new patients

Locations

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1710335237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7055 HIGH GROVE BLVD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7055 HIGH GROVE BLVD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277628",
            "telephone_number": "630-371-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YULE",
        "first_name": "NICOLE",
        "middle_name": "GRACE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.