Individual provider Active NPI

Jereme Trunk, DPT

  • Physical Therapist
  • Glenview, IL
National Provider Identifier
1730220021
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014669 Issued in IL
Practice address
1500 Waukegan Rd
Suite 250
Glenview, IL 60025-2100
Phone
(847) 657-9445
Fax
(847) 657-9450
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 070014669 IL Primary

Addresses

Primary practice location

1500 Waukegan Rd
Suite 250
Glenview, IL 60025-2100

Mailing address

1500 Waukegan Rd
Ste 250
Glenview, IL 60025-2100

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
070014669ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730220021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WAUKEGAN RD",
            "address_2": "STE 250",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WAUKEGAN RD",
            "address_2": "SUITE 250",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252100",
            "telephone_number": "847-657-9445",
            "fax_number": "847-657-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUNK",
        "first_name": "JEREME",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.