Individual provider Active NPI

Kristine C O'Connor, PT

  • Physical Therapist
  • Bensenville, IL
National Provider Identifier
1760504054
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-0064383 Issued in IL
Practice address
143 Bernice Dr
Bensenville, IL 60106-3366
Phone
(630) 350-2736
Fax
(630) 350-2842
NPI assigned
Apr 6, 2007
Last updated
Nov 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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 070-0064383 IL Primary

Addresses

Primary practice location

143 Bernice Dr
Bensenville, IL 60106-3366

Mailing address

6 Larkspur LN
Clarendon Hills, IL 60514-1015
Phone (630) 325-8851

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

LicenseStateTypeSpecialty
070-0064383ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flexeon Rehabilitation of Bensenville LLC Physical Therapist Past Accepting new patients
Elmhurst Rehabilitation,S.C. Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1760504054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LARKSPUR LN",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141015",
            "telephone_number": "630-325-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 BERNICE DR",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601063366",
            "telephone_number": "630-350-2736",
            "fax_number": "630-350-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "KRISTINE",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-0064383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.