Active NPI
Tracy Lynn Riley, MPT
- Specialist
- Palos Heights, IL
National Provider Identifier
1750583597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 11952 S Harlem Ave
Palos Heights, IL 60463-1167 - Phone
- (708) 923-1332
- Fax
- (708) 923-1263
- NPI assigned
- Jun 4, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | IL | Primary |
Addresses
Primary practice location
11952 S Harlem Ave
Palos Heights, IL 60463-1167
Mailing address
8239 Auburn LN
Frankfort, IL 60423-1717
Phone (815) 922-1582
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 |
|---|---|---|---|
| 070-010590 | IL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750583597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8239 AUBURN LN",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604231717",
"telephone_number": "815-922-1582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11952 S HARLEM AVE",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631167",
"telephone_number": "708-923-1332",
"fax_number": "708-923-1263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "TRACY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palos Heights, 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.