Individual provider Active NPI

Kristin Marie Lamb, DPT

  • Physical Therapist
  • Normal, IL
National Provider Identifier
1811168016
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070016553 Issued in IL
Practice address
1715 Bradford LN Ste 140
Normal, IL 61761-4177
Phone
(309) 888-4828
Fax
(309) 888-4930
NPI assigned
Mar 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 070016553 IL Primary

Addresses

Primary practice location

1715 Bradford LN Ste 140
Normal, IL 61761-4177

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other practice location 1

1704 Eastland Dr Ste 15
Bloomington, IL 61704-3580
Phone (309) 664-7766

Other names 1

  • Kristin McCord Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000845 IL Practitioner - Physical Therapist in Private Practice 4284777921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1715 Bradford LN
Suite 140
Normal, IL 61761-4177
Phone (309) 888-4828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070016553ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Feb 19, 2025 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Feb 19, 2025 Accepting new patients

Locations

1704 Eastland Dr
Ste 15
Bloomington, IL 61704
Phone (309) 664-7766

799 Central Ave
Ste 210
Highland Park, IL 60035
Phone (847) 433-5502

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

1715 Bradford Ln
Ste 140
Normal, IL 61761
Phone (309) 275-3802

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

3714 N Prospect Rd
Peoria, IL 61614
Phone (309) 550-7888

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1811168016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 BRADFORD LN STE 140",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614177",
            "telephone_number": "309-888-4828",
            "fax_number": "309-888-4930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1704 Eastland Dr Ste 15",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617043580",
            "country_code": "US",
            "telephone_number": "309-664-7766",
            "fax_number": "309-664-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAMB",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "MCCORD",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.