Individual provider Active NPI

Kaitlyn M Pasquinelli, DPT, PT

  • Physical Therapist
  • Bannockburn, IL
National Provider Identifier
1720488539
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.020941 Issued in IL
Practice address
2211 Waukegan Rd
Bannockburn, IL 60015-1570
Phone
(847) 267-8600
Fax
(847) 267-9520
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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 070.020941 IL Primary

Addresses

Primary practice location

2211 Waukegan Rd
Bannockburn, IL 60015-1570

Mailing address

2211 Waukegan Rd
Bannockburn, IL 60015-1570
Phone (847) 267-8600

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

LicenseStateTypeSpecialty
070.020941ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1720488539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 WAUKEGAN RD",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151570",
            "telephone_number": "847-267-8600",
            "fax_number": "847-267-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 WAUKEGAN RD",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151570",
            "telephone_number": "847-267-8600",
            "fax_number": "847-267-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASQUINELLI",
        "first_name": "KAITLYN",
        "middle_name": "M",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bannockburn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.