Kathleen Ann Carbone

Key facts

NPI

1851082804

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

227017783 (IL)

Practice address

1720 Lincoln Ave
Crest Hill, IL 60403-1928

Phone

(815) 685-6934

NPI assigned

May 18, 2023

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 18, 2023.

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1851082804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LINCOLN AVE",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031928",
            "telephone_number": "815-685-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 LINCOLN AVE",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031928",
            "telephone_number": "815-685-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONE",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227017783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crest Hill, IL

• Emma Buonicore
• Aimee Byrne, LCSW
• Cristina R Camara, MD
• Miguel Camara, M.D.
• Megan Kathleen Carbaugh, PA-C
• Caren Lynn Weisz
• Carolyn Whitfield, DPM, PC
• Donna G. Carver, O.D
• Catholic Charities of the Diocese of Joliet
• Center for Neurological Diseases

All providers in Crest Hill, IL · Massage Therapist in Illinois