Brenda J Tatham, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160002443 Issued in IL

Practice address

1010 Fairway Dr
Freeport, IL 61032

Phone

(815) 599-6000

NPI assigned

Feb 23, 2009

Last updated

Feb 23, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1851531495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 W STEPHENSON ST",
            "address_2": "PO BOX 857",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324864",
            "telephone_number": "815-599-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 FAIRWAY DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "61032",
            "telephone_number": "815-599-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATHAM",
        "first_name": "BRENDA",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160002443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shevawn Svehla, LCSW
• Swedishamerican Hospital
• Nancy Rebecca Sylvia, COTA/L
• Jennifer Talley
• Amanda Tatham, RBT-17-43450
• John Taylor
• Mark Steven Tedrow, RPH
• The Answer Physical Therapy & Medically Integrated Fitness LLC (The Answer Physical Therapy)
• The Monroe Clinic, Inc. (SSM Health Monroe Clinic Medical Group DME Freeport)
• The Monroe Clinic, Inc. (Monroe Clinic physician group Illinois medicare)

• Physical Therapy Assistant in Freeport, IL
• Providers in Freeport, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.