Kathleen Boron, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160003726 Issued in IL

Practice address

515 Cardinal Avenue
Oswego, IL 60543-7765

Phone

(630) 554-1126

NPI assigned

Jun 17, 2011

Sex

Female

Sole proprietor

No

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, last updated by the provider on Jun 17, 2011.

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1770878613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CARDINAL AVE",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437765",
            "telephone_number": "630-554-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CARDINAL AVENUE",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437765",
            "telephone_number": "630-554-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORON",
        "first_name": "KATHLEEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160003726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Marie Boazzo Glenn, D.C.
• Sherry L Bochenek
• Margaret Elizabeth Bollinger
• Michaela Bolosan
• Daniel L Borner Sr.
• Jennifer Borrowman
• Debarati Banerji Bose, MD
• Vincent Botta, A.P.N.
• Lindsay Brady
• Elizabeth Lassandrello Bremner

• All providers in Oswego, IL
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.