Active NPI
Dawn Garcia, PTA
- Physical Therapy Assistant
- Bellwood, IL
National Provider Identifier
1720224272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160004372
- Practice address
- 2615 Harrison St
Bellwood, IL 60104-2450 - Phone
- (708) 493-0199
- Fax
- (708) 493-9683
- NPI assigned
- Jan 5, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160004372 | IL | Primary |
| Specialist | 174400000X | 160004372 | IL |
Addresses
Primary practice location
2615 Harrison St
Bellwood, IL 60104-2450
Mailing address
2615 Harrison St
Bellwood, IL 60104-2450
Phone (708) 493-0199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160004372 | Other | IL | LICENSE |
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 |
|---|---|---|---|
| 160004372 | IL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509408000000",
"number": "1720224272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 HARRISON ST",
"city": "BELLWOOD",
"state": "IL",
"postal_code": "601042450",
"telephone_number": "708-493-0199",
"fax_number": "708-493-9683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 HARRISON ST",
"city": "BELLWOOD",
"state": "IL",
"postal_code": "601042450",
"telephone_number": "708-493-0199",
"fax_number": "708-493-9683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "DAWN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-05",
"last_updated": "2017-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160004372",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": "160004372",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "160004372",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.