Active NPI
Karen Mendez-Avila, ATC, ROT
- Athletic Trainer
- Algonquin, IL
National Provider Identifier
1801489547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000039576
- Practice address
- 650 S Randall Rd
Algonquin, IL 60102-5944 - Phone
- (815) 398-9491
- NPI assigned
- Feb 13, 2021
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000039576 | IL | Primary |
Addresses
Primary practice location
650 S Randall Rd
Algonquin, IL 60102-5944
Mailing address
1522 Golden Oak Dr
Woodstock, IL 60098-7712
Phone (815) 337-3670
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 |
|---|---|---|---|
| 2000039576 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1801489547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1522 GOLDEN OAK DR",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600987712",
"telephone_number": "815-337-3670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 S RANDALL RD",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601025944",
"telephone_number": "815-398-9491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEZ-AVILA",
"first_name": "KAREN",
"credential": "ATC, ROT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-13",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "2000039576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.