Active NPI
Camille Vondruska, PT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1841229549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070009255
- Practice address
- 100 E Walton St
Suite 700
Chicago, IL 60611-1448 - Phone
- (312) 642-3963
- NPI assigned
- Jul 3, 2006
- 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 | 070009255 | IL | Primary |
Addresses
Primary practice location
100 E Walton St
Suite 700
Chicago, IL 60611-1448
Mailing address
694 Forest Ave
Glen Ellyn, IL 60137-4121
Phone (630) 853-9467
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 |
|---|---|---|---|
| 070009255 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492560000000",
"number": "1841229549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "694 FOREST AVE",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601374121",
"telephone_number": "630-853-9467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E WALTON ST",
"address_2": "SUITE 700",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606111448",
"telephone_number": "312-642-3963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONDRUSKA",
"first_name": "CAMILLE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2017-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070009255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.