Evelyn Kerrick Eldridge, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

150.002827 Issued in IL

Practice address

3400 W Washington St
Springfield, IL 62711-7917

Phone

(217) 787-9600

NPI assigned

Jul 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1730345703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S PASFIELD ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043711",
            "telephone_number": "217-528-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W WASHINGTON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117917",
            "telephone_number": "217-787-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "EVELYN",
        "middle_name": "KERRICK",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "150.002827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hajar Amina El Amri, MD
• Aya El Jerbi, MD
• Ahmad El Kouzi, M.D
• Wendi Wills El-Amin, M.D.
• Rodger J Elble, M.D.
• Elite Iom LLC
• Mahmoud Elkhooly
• Jamarria Ell
• Kylee Marie Elleman, DO
• Jeremy Elliott

• Physical Therapy Assistant in Springfield, IL
• Providers in Springfield, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.