John Badagliacco, MS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2255 Campus Drive
Evanston, IL 60208-1050

Phone

(847) 491-5820

NPI assigned

Nov 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1710522123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 GREENTREE AVE",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152925",
            "telephone_number": "715-699-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CAMPUS DRIVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602081050",
            "telephone_number": "847-491-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADAGLIACCO",
        "first_name": "JOHN",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-08",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC CERTIFICATION",
            "identifier": "2000012256",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Evanston, IL
• Providers in Evanston, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.