Active NPI
Jenna Pascucci
- Physical Therapist
- Highland Park, IL
National Provider Identifier
1831708445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-025255
- Practice address
- 1919 Skokie Valley Rd
Highland Park, IL 60035-2361 - Phone
- (224) 765-5550
- Fax
- (224) 765-5551
- NPI assigned
- Jul 29, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-025255 | IL | Primary |
Addresses
Primary practice location
1919 Skokie Valley Rd
Highland Park, IL 60035-2361
Mailing address
900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-025255 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595980800000",
"number": "1831708445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 RAND RD STE 300",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600162359",
"telephone_number": "847-324-3976",
"fax_number": "847-929-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 SKOKIE VALLEY RD",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600352361",
"telephone_number": "224-765-5550",
"fax_number": "224-765-5551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASCUCCI",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-29",
"last_updated": "2020-07-29",
"certification_date": "2020-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-025255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.