Active NPI
Clementina Nkechi Solola, PT, DPT
- Physical Therapist
- Chicago, IL
National Provider Identifier
1902858046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-010257
- Practice address
- 1402 W 103Rd St
Suite 2
Chicago, IL 60643-2953 - Phone
- (773) 233-7800
- Fax
- (773) 233-7808
- NPI assigned
- May 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 070-010257 | IL | Primary |
Addresses
Primary practice location
1402 W 103Rd St
Suite 2
Chicago, IL 60643-2953
Mailing address
3013 Hermes Dr
Olympia Fields, IL 60461-1468
Phone (773) 233-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9437883 | Other | IL | PRIVATE HEALTHCARE SYSTEM |
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 |
|---|---|---|---|
| 070-010257 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357257600000",
"number": "1902858046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3013 HERMES DR",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611468",
"telephone_number": "773-233-7800",
"fax_number": "773-233-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 W 103RD ST",
"address_2": "SUITE 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606432953",
"telephone_number": "773-233-7800",
"fax_number": "773-233-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLOLA",
"first_name": "CLEMENTINA",
"middle_name": "NKECHI",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2013-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-010257",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "9437883",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
- Solo Eye Care & Eyewear Gallery, LLC
- Solo Eye Care Bridgeport PLLC
- Solo Eye Care Printers Row, PLLC
- Solo Eye Care University Village PLLC
- James M Solofra, D.D.S.
- Solomon Pesis DDS, Dental Outreach P.C.
- Solomon Primary Care Doctors LLC
- Jessie Tova Solomon-Greenbaum, M.A.
- Adina Gila Solomon
- Alfred Tawiah Solomon, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.